Esophagus duplication in a young adult.
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Adolescent↗
Biomedical subjects
P Castillo
Publications and source records attributed to P Castillo.
[Abdominal echography in patients with human immunodeficiency virus (HIV) infection. Diagnostic usefulness in the evaluation of associated medico-surgical pathology].
BASIS: The abdominal manifestations in the patient with HIV infection are increasingly frequent. We have conducted the present study in order to determine the diagnostic usefulness of the abdominal echography in the clinical assessment of the patient. MATERIALS AND METHODS: We review the echographic findings of 112 patients carrying the HIV with or without the Acquired Immunodeficiency Syndrome (AIDS). Seventy eight patients were men and 34, women, with an average age of 30 years. The main risk group was parenterally drug addiction (72%). The stage of the HIV infection was IVC1 in 41% of the cases, II in 23%, III in 13% and IVC2 in 13%. The echographic exploration was performed using a real-time echography, with a probe of 3.5 Mhz, assessing according to conventional criteria the abdominal organs and their pathology, masses and free intraabdominal fluid. The echographic characteristics were first broadly assessed in the patients from the series and later on, according to the patient's pathology. (Infectious, acute abdominal, hepatic biochemical disorders, HIV carrier-associated pathology). RESULTS: In 33% of the cases, the echography was normal. Hepatomegaly was the most frequent echographic sign: 56 patients (50%), followed by splenomegaly in 43 patients (38.3%), standing out the affection of the biliary and/or vesicular ductus in 7 patients (6.2%). The echographic findings were not related to the HIV infection stage, nor with the presence of hepatic biochemical disorders. However, the presence of organomegaly (hepatosplenomegaly associated or not to retroperitoneal adenopathies) were more frequent in the group with infectious complication, 33.3% vs 19.6% (p < 0.01), that in the patients without associated infectious processes. In patients with medical or surgical acute abdominal pathology, the echography was diagnostic in 9 out of 10 patients. CONCLUSION: In the HIV patient, the echography allows an specific initial diagnostic assessment, being able in most of the patients with abdominal manifestations to diagnose the causal pathology.
Abdomen↗
The control of jaw-opener motoneurons during active sleep.
Brainstem and spinal cord motoneurons that innervate somatic musculature serving antigravity functions are postsynaptically inhibited during active sleep. However, it has been reported that hypoglossal motoneurons (which do not innervate antigravity muscles) are not postsynaptically inhibited during active sleep, but are disfacilitated. In the present report we describe changes, during active sleep, in the excitability and membrane potential of digastric and synergistic motoneurons of the trigeminal motor pool; these neurons do not perform antigravity functions. The experiments described in the present report were performed in chronic cats that were prepared for intracellular recording. The motoneurons hyperpolarized an average of 11 mV (S.D. +/- 1.29, n = 8, P < 0.005) during active sleep compared to quiet sleep. Hyperpolarization was accompanied by a reduction in the excitability of the somadendritic regions of the neurons, as indicated by an increase in the delay of propagation of antidromic spikes from the initial segment to the somadendritic portion of the cell. High gain membrane potential recordings from these motoneurons revealed the occurrence of a remarkably large number of hyperpolarizing potentials during active sleep. When K-chloride-filled microelectrodes were utilized and chloride ions were injected intracellularly, the polarity of these potentials was reversed. During phasic episodes of active sleep, there was a clear increase in hyperpolarizing potential activity, a blockade of somadendritic spikes and phasic reductions in the amplitude of the initial segment spikes. Hyperpolarizing potentials occurred in conjunction with ponto-geniculo-occipital waves.(ABSTRACT TRUNCATED AT 250 WORDS)
Action Potentials↗
Autosomal dominant inheritance of thyroglossal duct cyst.
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Adult↗
[Attitudes and behaviour concerning tobacco use among physicians from Santiago].
The aim of this work was to study the prevalence, behavior and opinions towards smoking in a sample of 288 physicians from Santiago, stratified according to sex and specialty. The WHO Europe questionnaire was applied and smoker was defined as the person that consumed one or more cigarettes per day. Thirty six percent of the sample (40.2% of men and 23.8% of women) smoked an average of 9 cigarettes per day, compared to the figure of 28.3% obtained in a similar study in 1983. Fifty percent of smokers felt that they will not quit. No differences in knowledge about problems associated to smoking or forbidding smoking in hospitals, were observed between smokers and non-smokers. A majority of smokers did not smoke in front of their patients and did not allow smoking in their private clinics. It is concluded that, although a high proportion of physicians continue to smoke, their opinions and behavior will support smoking cessation efforts.
Adult↗
[Characterization of a multiresistant strain of Vibrio cholerae O1, isolated from a case of cholera in Chile].
This report characterizes a multiresistant Vibrio Cholerae O1 strain, isolated from a patient with cholera, and investigates the mechanism of resistance. The analyzed strain was resistant to tetracycline, chloramphenicol and trimethoprim-sulfamethoxazole. The resistance was mediated by a 101 megadalton plasmid that was transferred to the resultant of a conjugation assay between the multiresistant V. Cholerae strain and E. coli C-600 used as receptor strain, that acquired the triple resistance of the parental strain. The resistant V. cholerae strain had a Ogawa serotype, El Tor biotype and toxigenic capacity, demonstrated by ELISA and latex agglutination techniques. The biochemical features of the strain were identical to those of susceptible strains, except for the resistance to 10 and 150 ug o 129 vibriostatic factor. The emergence of plasmid mediated resistance to drugs of choice in the treatment of cholera must alert Chilean and Latin American health authorities, considering the cholera will continue affecting the region.
Anti-Bacterial Agents↗
[New medical schools in Chile].
In Chile there are six established medical schools at public (Chile, Valparaiso and Temuco) or private (Catholic, Concepción and Austral) universities created between 1833 and 1971. Since 1990, three new medical schools (two private) were created and a fourth is projected, concerning the chilean medical corps. We present three position articles on the subject written by Dean Pedro Rosso, from the Catholic University, Dr Pedro Castillo, Chief of Human Resources of the Ministry of Health and Dean Alejandro Goic from the University of Chile. Dean Rosso emphasizes the need to have assessment procedures that guarantee quality standards in the new medical schools. Dr Castillo attracts attention on preserving the compromise with the society, inherent to chilean medicine. Dean Goic analyzes systematically the reasons to prevent the proliferation of medical schools in the country, maintaining an equilibrium between freedom of teaching and public faith protection.
Chile↗
Maternal mortality estimation.
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Developing Countries↗
Controlled diet in phenylketonuria may cause serum carnitine deficiency.
Serum carnitine levels may be reduced in patients with phenylketonuria (PKU) owing to low carnitine intake, deficient carnitine synthesis and acylcarnitine production from phenylalanine metabolites. In order to investigate the possible carnitine deficiency we determined serum carnitine in its different forms and the precursors and cofactors involved in its synthesis in a group of patients with PKU or hyperphenylalaninaemia. Free, total and acylcarnitine values were significatively reduced only in PKU patients with Phe-restricted diet which had not been supplemented with carnitine. Acylcarnitine/free carnitine ratio and all the other parameters studied were normal in all patients. We conclude that the low serum carnitine levels in PKU patients with a strict diet are a consequence of the low carnitine intake.
Adolescent↗
[Pleuroperitoneal shunt in the treatment of pleural effusion associated with cirrhosis].
Some patients with unbalanced hepatic cirrhosis may develop a recidivant pleural leakage resulting in relevant gas interchange disorders. In the treatment of recidivant pleural leakage, evacuative thoracocentesis and pleurodesis may be used. If these procedures fail, pleurectomy or surgery may be used, although with relevant morbidity and mortality rates. Another option, used mainly for malignant leakages, is the placement of a pleuroperitoneal shunt. We present the case of a patient with recidivant pleural leakage associated to hepatic cirrhosis, in which after the failure of paracentesis and pleurodesis, a pleuroperitoneal shunt was successfully inserted. The pleuroperitoneal shunt may be a therapeutical alternative in the recidivant pleural leakage associated to cirrhosis.
Aged↗
Effect of fat and fat-free mass deposition during pregnancy on birth weight.
OBJECTIVES: The purposes of our study were to describe the patterns and location of fat and fat-free mass deposition during pregnancy and to evaluate their effects on fetal growth. STUDY DESIGN: Our study is a prospective follow-up of 105 healthy pregnant women who were delivered of term infants. Body composition was evaluated eight times during gestation with anthropometric measures and bioimpedance techniques. Body fat and fat-free mass were calculated with equations specifically developed for this population. RESULTS: Total weight gain was 10.0 +/- 3.5 kg; net weight gain was 3.7 +/- 0.31 kg; birth weight was 3211 +/- 467 gm (values are mean +/- SEM). In these women fat was deposited mostly in the thigh and subscapular region for a total of 6.23 +/- 0.19 kg at term. The period of pregnancy of the largest maternal fat deposition per week is between the twentieth and thirtieth weeks. After adjusting by prepregnancy weight, birth weight is associated with maternal changes in thigh skin folds and fat gain before the thirtieth week of gestation. Infants born to mothers with low fat gain before the thirtieth week were 204 gm lighter than infants born to mothers with fat gain > or = 25th percentile of this population. CONCLUSION: Maternal nutritional status at the beginning of gestation and the rate of fat gain early in pregnancy are the two nutritional indicators most strongly associated with fetal growth in this population.
Adipose Tissue↗
Effect of the infusion of p-Glu-His-Ala-OH, analog of the anorexigenic peptide, on the insulin response induced by intravenous glucose. Preliminary results with obese subjects.
The effect of the intravenous infusion of peptide p-Glu-His-Ala-OH, analog of the postulated anorexigenic peptide, on the insulinaemic response to an intravenous bolus of 20 g glucose was studied in 6 obese patients (body mass index 43.12 +/- 5.77 kg/m2). The infusion of the peptide reduced the insulinaemic response (p < 0.05) without modifying either the C-peptide or the glucose response. This decreased insulinaemic response is associated with a greater hepatic extraction of insulin (86.45 +/- 1.1% vs 82.1 +/- 1.2%; p 0.05), determined in terms of the molar ratio of the C-peptide to insulin) but not with a smaller pancreatic secretion (determined as C-peptide levels). Our results confirm that the infusion of the peptide increases the hepatic insulin extraction without its effect being mediated by any intestinal factor. Its therapeutic application remains to be determined.
Adult↗
Strychnine blockade of the non-reciprocal inhibition of trigeminal motoneurons induced by stimulation of the parvocellular reticular formation.
Stimulation of a region within the parvocellular medullary reticular formation (PcRF) that contains somas of premotor interneurons produces short latency inhibitory synaptic potentials (IPSPs) in cat trigeminal motoneurons. The present study was undertaken to determine whether glycinergic synapses are responsible for these IPSPs. The intravenous administration of strychnine, an established glycine antagonist, abolished these PcRF-IPSPs. This effect appears to be specific for glycinergic inhibitory synapses because the short lasting component of the IPSP produced by inferior alveolar nerve (IAN) stimulation was also abolished, whereas, in contrast, the long lasting non-glycinergic component of this IPSP was not suppressed. These results indicate that a glycinergic system in the reticular formation is responsible for the non-reciprocal postsynaptic inhibition of trigeminal motoneurons.
Animals↗
A medullary inhibitory region for trigeminal motoneurons in the cat.
The present report describes the effects on trigeminal motoneurons of stimulation of a circumscribed site within the parvocellular region of the medullary reticular formation. This medullary site was selected because anatomical studies have shown that premotor interneurons project from this site to the trigeminal motorpool. Electrical stimulation of this site induced IPSPs (PcRF-IPSPs) in jaw-closer motoneurons. A population of these IPSPs, recorded contralateral to the site of stimulation, exhibited latencies shorter than 1.5 ms (mean 1.16 +/- 0.08 SD). Their mean amplitude was 1.72 mV +/- 1.13 SD and their mean duration was 3.52 ms +/- 2.15 SD. We believe that these PcRF-IPSPs arose as the result of activation of a monosynaptic pathway. A comparable inhibitory input from this site to ipsilateral jaw-closer motoneurons and to both contra and ipsilateral digastric motoneurons was also observed. We therefore conclude that this medullary PcRF site contains premotor interneurons that are capable of postsynaptically inhibiting motoneurons that innervate antagonistic jaw muscles.
Animals↗
Meal size and frequency: effect on the thermic effect of food.
The effects of meal size and frequency on thermic effect of food (TEF) were examined in seven healthy normal-weight young women. Each volunteer consumed in random order one of two identical meals [3138 kJ (750 kcal), 54.5% carbohydrate, 14.0% protein, 31.5% fat]. One meal was taken over 10 min [large meal (LM)] whereas the other was taken in six equal portions of 523 kJ (125 kcal) at 30-min intervals over a 3-h period [small meals (SM)]. Metabolic rate was measured for 1 h before and every 30 min after the meal started for 5 h. When expressed as either kJ/min (kcal/min) or kJ/5h (kcal/5h), TEF was significantly higher in the LM day than in the SM day (P less than 0.05). We conclude that the temporal pattern in which a mixed caloric load is eaten affects the thermogenic response and may be an important determinant of energy balance after a meal.
Adult↗
Non-reciprocal postsynaptic inhibition of digastric motoneurons.
This study was undertaken to explore the effects, on digastric motoneurons, of electrical stimulation of a site within the parvocellular medullary reticular formation (PcRF). This site is located lateral to the hypoglossal nucleus and ventral to the dorsal motor nucleus of the vagus nerve. Within this site are somas of premotor interneurons that project to trigeminal motor nuclei. Stimulation of this site resulted in the generation of IPSPs in digastric motoneurons. We postulate that these IPSPs were due to the activation of a monosynaptic path from the PcRF to digastric motoneurons. The present results, in conjunction with those previously reported which indicate that the PcRF also induces monosynaptic IPSPs in masseter motoneurons, demonstrate that this is a site of origin for the postsynaptic inhibitory control of motoneurons that innervate both jaw opening and closing muscles.
Animals↗
[Ill-defined causes of death in the elderly].
Over one-half of death certificates from elderly people contain ill-defined causes of death. Usually, signs and symptoms rather than causes of death are registered. Electrolyte imbalance, decubitus ulcer, atherosclerosis, diabetes, etc are some of the most frequently quoted conditions. Adequate preventive programs are jeopardized by lack of more precise information regarding the cause of death and relevant associated conditions in the elderly.
Aged↗