Angiographic changes induced by intracoronary ultrasound imaging before and after coronary angioplasty.
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Aged↗
Biomedical subjects
R Hernandez
Publications and source records attributed to R Hernandez.
Burn injury decreased splanchnic PGI2 release is restored by treatment with lazaroid.
This study examined the hypothesis that burn injury inhibits the release of splanchnic PGI2, a potent endogenous vasodilator of the splanchnic vascular bed. Male Hartley Guinea Pigs (350 grams) were anesthetized, shaved and subjected to a full thickness scald burn comprising 45% of the total body surface area (or sham burn). The animals were treated with intravenous or topical lazaroid, a 21-aminosteroid U75412E. After recovery for 24 hours, the animals were anesthetized, and the superior mesenteric artery was cannulated and removed with its intact intestine (SV + SI). The SV + SI was perfused in vitro with oxygenated Krebs buffer. The venous effluent was assayed for 6-keto-PGF1 alpha, PGE2 and thromboxane B2 by enzyme immunoassay. Acute burn injury decreased SV + SI release of 6-keto-PGF1 alpha by 57% but did not alter release of PGE2 or thromboxane B2. Treatment of the animals with topical lazaroid and not intravenous lazaroid restored SV+SI 6-keto-PGF1 alpha release to control levels. These data showed that topical lazaroid therapy maintained endogenous splanchnic PGI2 release following acute burn injury. Maintaining endogenous splanchnic PGI2 release by topical lazaroid treatment may be one strategy to avoid splanchnic ischemia following acute thermal injury.
6-Ketoprostaglandin F1 alpha↗
Endotoxic shock has differential effects on renal and splanchnic eicosanoid synthesis.
This study examined the differential effects of endotoxin on renal and splanchnic vascular (SV + SI) eicosanoid synthesis. Dogs were anesthetized and subjected to a challenge of 1 mg/kg (i.v.) bolus of B-lipopolysaccharide endotoxin followed by a 3 h infusion of endotoxin at 0.5 mg/kg/h. The kidney and SV + SI were cannulated and perfused in vitro with Krebs buffer. The venous effluent from the kidney and SV + SI were assayed for 6-keto-PGF1a (PGI2), PGE2, Leukotriene B4 (LTB4), LTC4, and thromboxane B2 (TXB2) by enzyme immunoassay. Endotoxin treatment markedly increased splanchnic PGI2 release (splanchnic vasodilator) two fold and decreased release of all other measured eicosanoids. Endotoxin treatment markedly increased renal PGE2 (renal vasodilator) but did not significantly increase PGI2. These data showed that endotoxin treatment stimulated both the splanchnic vascular bed and kidney to increase synthesis and release of their major endogenous vasodilator eicosanoids.
Animals↗
Exaggerated splanchnic PGI2 release following acute hemorrhage is due to new protein synthesis.
The effect of cycloheximide on increased splanchnic prostacyclin release following acute hemorrhage was studied in the rat. Male Sprague-Dawley rats were anesthetized and subjected to acute hemorrhage to 30 mm Hg for 30 min (shock) or sham shock. The superior mesenteric artery was cannulated and removed with its end organ intestine (SV + SI preparation) and perfused in vitro with oxygenated Krebs-Henseleit buffer. Cycloheximide was infused in half of the sham and acute hemorrhage SV + SI preparations at 50 micrograms/ml. Venous effluent from all groups were analyzed for prostanoid release by radioimmunoassay. The SV + SI released 10-fold more 6-keto-prostaglandin (PG) F1 alpha than PGE2 and thromboxane. Acute hemorrhage increased SV + SI release of 6-keto-PGF1 alpha 3-fold compared to sham. Cycloheximide abolished the increased 6-keto-PGF1 alpha following acute hemorrhage but not the basal release in the sham group. Indomethacin decreased PG synthesis in all groups by 90%. Sham PG release was dependent on a stable pool of cyclooxygenase with a long half-life and was not affected by cycloheximide treatment. Acute hemorrhage stimulated a rapid induction of enzymes (cyclooxygenase, prostacyclin synthase) responsible for prostacyclin synthesis and release which were dependent on de novo protein synthesis.
6-Ketoprostaglandin F1 alpha↗
Prostacyclin regulates splanchnic blood flow during early hemorrhage/reperfusion injury.
The effect of oxygen radicals on superior mesenteric artery (SMA) blood flow and splanchnic prostaglandin release was examined during early hemorrhage/reperfusion injury. Sprague-Dawley rats were hemorrhaged to 30 mm Hg for 5, 10, or 15 min without (SK5, SK10, and SK15) or with (SK10+R, and SK15+R) blood reperfusion. The SK15+R group were treated with or without superoxide dismutase (SOD 10 000 units/kg intravenously). In vivo SMA blood flow was measured continuously for 100 min by a transonic flow probe. The in vitro-perfused superior mesenteric artery and end organ intestine (SV+SI) were assayed for release of 6-keto-PGF1 alpha, thromboxane B2 (TXB2) and PGE2 by radioimmunoassay. Acute hemorrhage for 10 and 15 minutes increased SV+SI 6-keto-PGF1 alpha release 2-fold and 10-fold respectively compared to the sham (p < 0.01), which was abolished by blood reperfusion. SMA blood flow was decreased by 4% and 60% in the SK10+R and SK15+R groups respectively compared with the sham (p < 0.01). SOD treatment restored both SV+SI release of 6-keto-PGF1 alpha and SMA blood flow to control levels in the SK10+R and SK15+R groups. Oxygen-derived free radicals produced within 15 min of acute hemorrhage/reperfusion injury inhibited splanchnic PGI2 synthesis, which contributed to decreased splanchnic blood flow.
Animals↗
The role of bone scintigraphy in detecting child abuse.
This review of diagnostic imaging in cases of suspected child abuse characterizes the significant differences between bone scintigraphy and x-ray evaluation, describes the advantages and disadvantages of each modality, postulates on the specific mechanisms of injury that produce the characteristic scintigraphic findings, and emphasizes the influences that scintigraphic studies have on the medical, social, and legal aspects of child abuse. The major advantages of bone scintigraphy are its increased sensitivity (25% to 50%) in detecting evidence of soft tissue as well as bone trauma in child abuse. Furthermore, it is postulated that the specific mechanisms of inflicting the trauma relate to the patient's size and are characterized by bone scintigraphy. During fits of anger or frustration, the perpetrator of child abuse grasps the small infant or child by the thorax during the shaking activity. This produces characteristic rib injuries. The older and heavier child is more likely to be grabbed by the extremities, which produces periosteal injuries manifested as characteristic abnormal localizations in the diaphyses of the extremities. The roentgenograms of these injuries are frequently normal. The importance of bone scintigraphy is its complementary nature in defining and characterizing the extent and severity of trauma from child abuse. Such findings have direct bearing on the medical, social, and legal outcomes for the abused child. The quality of scintigraphic imaging is important, requiring the use of magnification techniques in the infant. The interpretation of the scintigraphic images depends on an understanding of the mechanisms by which the radionuclide localizes in bone. The same traumatic incident can lead to decreased, normal, or increased localization at the trauma site. Radionuclide scintigraphy is a complementary rather than competitive imaging modality to X-ray evaluation in the diagnosis and management of physical child abuse.
Bone and Bones↗
Percutaneous transluminal coronary angioplasty for post-infarction angina in elderly patients.
To assess the short-term outcome of percutaneous coronary angioplasty (PTCA) for post-infarction angina in elderly patients, we have retrospectively evaluated the results of 88 procedures of PTCA (98 lesions attempted), performed for post-infarction angina (PIA), in 84 patients of > or = 65 years (elderly group), and compared the results obtained with those of 165 PTCAs (200 lesions attempted) in 161 patients of < 65 years old with PIA (young group). Angiographic success was obtained in 91 (93%) vs. 181 (91%) of lesions attempted in the groups, respectively. Complete revascularization was achieved in 54 (61%) patients treated in the elderly group vs. 106 (65%) in the young group. PTCA success was obtained in 78 (89%) procedures vs. 147 (89%) of both groups. No patients required emergency coronary surgery, two patients (2%) had a reinfarction in the elderly group vs. five patients (3%) in the young group, and two patients died (one in the elderly and one in the young group). In conclusion, PTCA for PIA in elderly patients provides a high clinical success rate with a low frequency of complications, similar to the results obtained in young patients.
Age Factors↗
Screening elders for risk of hospital admission.
OBJECTIVE: To define a set of screening criteria that identifies elders who are at high risk for repeated hospital admission in the future. DESIGN: Longitudinal cohort study. Logistic regression analysis of data from half of the subjects was used to identify risk factors for repeated hospital admission. The ability of these risk factors to identify elders who are at high risk for repeated hospitalization in the future was then tested using data from the other half of the subjects. SETTING: United States. PARTICIPANTS: A subsample (n = 5876) of a multistage probability sample of all non-institutionalized U.S. civilians who were 70 years or older in 1984. MEASUREMENTS: At baseline (1984), elderly subjects were asked about their demographic, socioeconomic, medical, and functional characteristics and about their recent use of health services. Their subsequent hospital admissions and mortality were then monitored through the records of the Medicare program and the National Death Index (1985-88). RESULTS: Among the subjects in the first half of the sample, eight factors emerged as risk factors for repeated admission: older age, male sex, poor self-rated general health, availability of an informal caregiver, having ever had coronary artery disease, and having had, during the previous year, a hospital admission, more than six doctor visits, or diabetes. Based on the presence or absence of these factors in 1984, 7.2% of the subjects in the second half of the sample were estimated to have a high probability of repeated admission (Pra > or = 0.5) during 1985-1988. In comparison with subjects estimated to have a low risk (Pra < 0.5), this high-risk group's actual experiences during 1985-1988 included a higher cumulative incidence of repeated admission (41.8% vs 26.2%, P < 0.0001), a higher cumulative rate of mortality (44.2% vs 19.0%, P < 0.0001), more hospital days per person-year survived (5.2 vs 2.6), and higher hospital charges per person-year survived ($3731 vs $1841). CONCLUSION: Eight easily ascertained risk factors affect elders' probability of being hospitalized repeatedly within four years. In the future, brief surveys about the presence of these factors could be used to estimate elders' risk of future hospitalization and, thereby, to identify some of those who may derive the greatest benefit from interventions designed to avert the need for hospitalization.
Aged↗
Site density of mouse intestinal glucose transporters declines with age.
To evaluate the effect of age on nutrient transport, the absorption rates of D-glucose, D-fructose, L-alanine, L-aspartate, L-leucine, L-lysine, L-proline, folic acid, and nicotinamide were determined in isolated jejunal tissues of young (6.7 mo old) and aged (23.7 and 27.0 mo old) mice (COBS:SFW). D-Glucose and D-fructose uptakes per milligram tissue were approximately 20-120% higher in the proximal jejunum and 15-50% higher in the distal jejunum of young mice. Amino acid and vitamin uptakes per milligram were also higher in young mice, but differences were not statistically significant. The number of Na(+)-D-glucose transporters per milligram tissue as estimated by specific phlorizin binding decreased with age. There was no age-related change in passive L-glucose permeability, in Kd of specific phlorizin binding, in transporter turnover rate, and in the molecular weight of the Na(+)-D-glucose transporter. Thus a reduction in D-glucose transporter site density fully accounts for the age-related decline in D-glucose transport rate per milligram small intestine.
Aging↗
Trypanosoma cruzi ribosomal RNA genes: a review.
Our research work group has been interested in the study of the ribosomal RNA and 5S gene systems from Trypanosoma cruzi. Our contributions span from the general description of a multifragmented molecular system, to the sequence analysis of some ribosomal RNA coding regions. From the latter, we have constructed phylogenetic trees of the Trypanosomatidae family, and our data indicate that the molecular inferences do not sustain the traditional classification of these species. Our published findings are here reviewed along with recent unpublished observations of ribosomal RNA and 5S gene structures.
Animals↗
Mortality in hypertensive patients in Hospitalet de Llobregat, Barcelona (Spain).
A retrospective cohort study was carried out on 729 hypertensive patients (male and female 40 years and older) in Hospitalet de Llobregat (Barcelona, Spain) to assess possible differences between the mortality of this group of hypertensives and the general population of the same area matched by age and sex. Patient mortality was assessed during a six year period, resulting in a mean follow-up of 2.6 years at the end of the study. The results reflect an increased risk of dying among hypertensives compared with the general population, with standardised mortality ratio by age and sex of 1.88 (95% confidence interval 1.21-2.44). Cardiovascular mortality was significantly higher for males, while noncardiovascular mortality was significantly higher for females. The study also shows that the presence of smoking habit, diabetes or hyperglycaemia, uncontrolled hypertension and age > or = 60 years can increase the risk of dying among hypertensive patients. Although a higher level of BP control is achieved in hypertension hospital clinics than in the primary health care system, the study shows that hypertensives have an excess of mortality than expected considering their own general population by age and sex.
Adult↗
Acute dilated cardiomyopathy as a cluster in children.
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Adolescent↗
Construction of a bite plane with light-cured resin.
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Acrylic Resins↗
Predictors, mechanisms and outcome of severe mitral regurgitation complicating percutaneous mitral valvotomy with the Inoue balloon.
During 241 consecutive percutaneous mitral valvotomy (PMV) procedures performed with the Inoue balloon, 16 patients (6.6%) developed severe mitral regurgitation (MR). Baseline clinical, echocardiographic (Doppler mitral valve area and Wilkins' score) and hemodynamic data were not different from those of patients without this complication. Severe MR occurred during the first inflation in 7 patients and after several stepwise inflations in 9. Although maximal balloon size was similar in both groups, unusual indentations and subvalvular inflations were more frequently observed in patients who developed severe MR. Early mitral valve replacement was required in 6 patients. All of them had a leaflet rupture either along the midportion (2 patients), along a commissure (4 patients), or both. Commissural calcium was present in 5 valves and 5 also had severe subvalvular involvement that had been underestimated by echocardiography. Of the 10 nonsurgically treated patients, 4 had chordal rupture by echocardiographic criteria, whereas in the remaining 6 the precise mechanism of MR could not be determined. During follow-up (11.4 +/- 4 months, range 1 to 30), 1 patient required surgery for symptoms and the remaining 9 were symptomatically improved and free of left ventricular dilatation. In conclusion, severe MR complicated 6.6% of PMV procedures with the Inoue balloon, and its mechanism was leaflet or chordal rupture. Although one third of the patients required early mitral surgery, most of the remaining obtained midterm symptomatic benefit.
Adult↗
Regulation of glutathione metabolism in Ehrlich ascites tumour cells.
Glutathione metabolism was studied in cancer cells during the growth of an Ehrlich ascites tumour. GSH, but not GSSG, content decreases when cell proliferation and the rate of protein synthesis in the tumour decrease. This change correlates with a decrease in the rate of GSH synthesis and an increase in glutathione peroxidase and glutathione S-transferase activities. Glutathione efflux from tumour cells seems to co-ordinate with the rate of GSH synthesis. Cysteine, and not methionine, promotes GSH synthesis in tumour cells. However, changes in the rate of GSH synthesis are not due to limitations in the supply of blood cysteine or to changes in the intracellular amino acid pool of the cancer cells. Our data suggest that changes in protein metabolism accompanying tumour growth in vivo can modulate glutathione content in cancer cells.
Acetylcysteine↗
Stenting for elastic recoil during coronary angioplasty of the left main coronary artery.
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Aged↗
Comparison of results of percutaneous transluminal coronary angioplasty with and without selective requirement of surgical standby.
To determine the outcome of percutaneous transluminal coronary angioplasty (PTCA) with the use of 2 different strategies of surgical coverage, the results of 1,283 consecutive PTCAs were analyzed. In 269 procedures (21%) (patients considered at high risk should acute vessel closure occur--standby group) the operating room and the surgical team were ready for an immediate intervention. In the remaining 1,014 procedures (79%) (backup group), although the surgical team was "in house," they were not necessarily ready for an immediate intervention. Mean age of the population was 58 +/- 10 years and 84% of patients were men. Coronary risk factors, medical treatment, clinical indication for PTCA, previous coronary surgery and left ventricular ejection fraction were similar in both groups. Dilatation was more frequently multiple (23 vs 16%, p less than 0.05), or performed in the left anterior descending coronary artery (71 vs 46%, p less than 0.001), in bypass grafts (4 vs 2%, p less than 0.02), in proximal coronary segments (72 vs 57%, p less than 0.001) or in lesions at bifurcation (35 vs 28%, p less than 0.02) in the standby than in the backup group, respectively. PTCAs were less frequently performed during the same diagnostic procedure (15 vs 34%, p less than 0.001) in the standby group. Angiographic success was obtained in 91 and 92% of the attempted lesions and PTCA success in 89 and 88% of the procedures in the standby and backup groups, respectively. The incidence of death (1 vs 0.7%), acute myocardial infarction (2.9 vs 2.7%) and emergency surgery (0.7 vs 0.1%) was also similar in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)
Aged↗
Comparison of results of percutaneous mitral valvuloplasty in patients with large (greater than 6 cm) versus those with smaller left atria.
To determine whether the presence of an aneurysmatic (severely enlarged) left atrium (greater than 60 mm on echocardiography) influences results of percutaneous mitral valvuloplasty (PMV), the clinical, echocardiographic and hemodynamic characteristics and the results of this technique were compared in 46 consecutive patients with aneurysmatic left atrium (group I) and 125 consecutive patients without such echocardiographic finding (group II). Left atrial size was 70.5 +/- 8 vs 50.1 +/- 6 mm (p less than 0.005) in groups I and II, respectively. Patients in group I were older (57 +/- 12 vs 48 +/- 12 years, p less than 0.025), more symptomatic (New York Heart Association functional class greater than or equal to III or IV: 67 vs 42%, p less than 0.05), and had atrial fibrillation more frequently (91 vs 44%, p less than 0.001). The echocardiographic score (8.9 +/- 1.9 vs 7.5 +/- 2, p less than 0.005) and the incidence of mild mitral regurgitation on angiography before PMV (54 vs 30%, p less than 0.01) was also higher in group I patients. Hemodynamic parameters before PMV were similar in both groups, but after the procedure, final mitral valve area (1.61 +/- 0.5 vs 1.95 +/- 0.4 cm2, p less than 0.05) and the absolute increase in mitral area (0.81 +/- 0.3 vs 1.02 +/- 0.3 cm2, p less than 0.05) were lower and mean pulmonary artery pressure (35 +/- 10 vs 28 +/- 9 mm Hg, p less than 0.025) was higher in group I.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗