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Biomedical subjects

P Naranjo

Publications and source records attributed to P Naranjo.

43 records · Page 3Linked to original sources
PubMedDate not supplied

A 2 year evaluation of diabetic patients on continuous ambulatory peritoneal dialysis.

Nineteen diabetic patients with end-stage renal disease on CAPD were evaluated over a 2 year period. All but one patient was insulin-dependent, with a mean age of 47.7 years. Average time on CAPD was 16.1 months (range, 2-28 months). Thirteen patients were followed for more than 12 months, and nine for more than 18 months. The mean training period was 22.9 days. Good blood glucose control was obtained with intraperitoneal (IP) insulin in all of the patients. Mean blood glucose levels of 125 +/- 23.08 mg/dl were achieved with 103 +/- 38.5 U/day of regular IP insulin. Glycosalated hemoglobin decreased from a mean of 12.7 +/- 2.35% before CAPD to 10.08 +/- 0.97% during CAPD. Peritoneal creatinine clearance remained stable during the study period, with a concommitant decrease (P less than 0.001) in the mean residual renal creatinine clearance. The incidence of peritonitis was one episode per 7.8 patient-months. Average length of hospitalization was 33.24 days/year. Visual acuity remained stable after 1 year in 73% of the 26 eyes evaluated. No amputations were required in more than 2 years of follow-up. Actuarial survival was 100% at 1 year and 86% at 2 years, and the technique survival of CAPD was 91 and 79%, respectively. These results demonstrate that CAPD is a good dialysis procedure for treating diabetic patients with chronic renal failure, and it offers the advantage of controlling glycemia better than other dialysis methods.

Adult↗
PubMedDate not supplied

Epidemic hecatomb in the New World.

The American population developed, during thousands of years, free of epidemics that had been attacking Europe, Asia and Africa. The European and African migrations, after Columbus's first trip, produced an epidemic invasion of influenza, smallpox, measles, yellow fever, malaria, diphtheria, typhus, and other diseases that attacked the immunologically virgin populations and produced a very high mortality, with a diminution of the indigenous population of more than 90% in many places. According to historical evidence, the first epidemic was influenza, produced by swine strain of virus, immediately followed by smallpox. The Spaniards mated freely with the Indians producing a mixed race called the Mestizo, who were immunologically more capable of defending themselves against various viruses, bacteria, and parasites brought over from the Old World. Marriage between the races also was sanctioned by Queen Isabella (1503) and Fernando I (1515). With these new genetic immunologic defenses against infections, the Mestizo eventually made up the majority of the population of Indians in the New World.

Communicable Diseases↗
PubMedDate not supplied

[Mediators of the allergic reaction. Slow reacting substance (SRS-A)].

The slow reacting substance of anaphylaxis (SRS-A) belongs to a group of substances which produce a slow progressive and sustained contraction of some smooth muscles. It is released by the interaction of the antigen with certain antibodies; in humans through the interaction with the IgE or reagine. The SRS-A is a heat-labile sustance, chemically unstable, of an acid character, with a low molecular weight. It is not destroyed by the action of proteolytic enzymes. Its molecular structure has not yet been elucidated. It is not found accumulated in the cells but synthesized and released by some white cells mainly by sensitized mast cells and polymorphonuclear leukocytes after challenging with the specific antigen. The SRS-A is a powerful pharmacodynamic agent, it produces contraction of the bronchial smooth muscle in doses of nanograms. It probably plays a predominant role in the physiopathology of asthma. The chain of chemical reactions elicited by antigen-antibody interaction does not end with the release of SRS-A and the other mediators (histamine, eosinophil chemotactic factor of anaphylaxis, ECF-A), on the contrary, these mediators especially SRS-A induce the release of prostaglandins of type E (PGE1 and PGE2) which produce bronchodilatation and inhibit the release of SRS-A itself, perhaps being a selfregulating mechanism. The PGF2a, on the other hand, produces bronchoconstriction. The release of SRS-A is also inhibited by the action of diethyl-carbamazine and especially by sodium chromoglicate and compound AH-7725. From the biochemical point of view it is found that the antigen Igells, a serine esterase, initiating several chemical reactions whose consequence is a decrease in the cAMP concentration. This reduction in the cAMP intracellular level is followed by synthesis and excretion of the SRS-A as well as by the aggregation of the microtubules and excretion of the stored histamine. The PGE (1 and 2) acting on one type of membrane receptor and the beta-agonist catecholamines on another produce a common phenomenon: the activation of the adenylcyclase whcih produces the increase of the concentration of cAMP and inhibits the release of mediators of the anapylactic reaction. The parasympathetic system through its chemical mediator acethylcholine, by a mechanism in whcih adenycyclase is not involved is also capable of stimulating the release of histamine and SRS-A. Something similar happens with PGF2a. In conclusion, self-regulatory mechansims for the release of mediators of the anaphylactic reactions may exist. The "perpetuation" of an asthamtic reaction would signify a failure of these self-regulatory mechanisms due to, for example, to a temporary block of the beta-adrenergic receptors, overstimulation of the alfa-receptors or insufficient production of PGE or a transformation of the PGE in PGF.

Adrenergic beta-Antagonists↗