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Biomedical subjects

R Miranda

Publications and source records attributed to R Miranda.

At least 73 records · Page 4Linked to original sources
PubMed1993

[Cancer of the middle third of the choledochus: an infrequent diagnosis].

We report the case of an 80-year-old woman with a previous history of HBP, hysterectomy due to cancer of the uterus and cholelithiasis, who was admitted in our hospital because of diffuse abdominal pain, marked jaundice, choluria and acholia during one week, together with anorexia and loss of weight. Blood chemistry results disclosed a total bilirubin of 11 mg/dl, a direct bilirubin of 8 mg/dl, GGTP 826 U/I, alkaline phosphatase 287 U/I, AST 285 U/I, ALT 837 U/I and LDH 242 U/I. The CA 19-9 marker was higher than 500 U/ml. The abdominal ultrasound examination did not show any space-occupying lesions; the extra and intrahepatic bile ducts were very dilated and the gall bladder showed multiple stones within its contents. The endoscopic retrograde cholangiopancreatography (ERCP) showed a homogeneous filiform defect at the middle third of the common bile duct of approximately 1 cm in length and with a marked dilatation of the bile ducts. A percutaneous drainage of the bile tree was performed, but the patient died.

Aged↗
PubMed1992

Measured vs calculated plasma osmolality in infants with very low birth weights.

OBJECTIVE: To determine the relationship between measured serum osmolality (MsOsm) and calculated osmolality and to examine factors that may affect the osmolal gap. RESEARCH DESIGN: Longitudinal cohort study. SETTING: Regional tertiary neonatal intensive care nursery in a university-affiliated hospital. PATIENTS: Sixty low-birth-weight infants (birth weight, 540 to 1500 g), studied daily during the first week of life. SELECTION PROCEDURE: Consecutive sample. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: The MsOsm was significantly higher than the calculated osmolality for the first 6 days of life. The MsOsm was significantly higher during the first 6 days of life in infants with birth weights less than 1000 g than in those with birth weights greater than 1000 g, but the calculated osmolality was similar in both groups. Intraventricular hemorrhage, preservative additives in drugs, and packed red blood cell transfusions did not contribute significantly to osmolal gap or MsOsm. In 19 patients, peak MsOsm was greater than or equal to 320 mmol/kg (mean, 336 +/- 13 mmol/kg; calculated osmolality, 298 +/- 20 mmol/kg; osmolal gap, 38 +/- 19 mmol/kg). Six of these 19 patients died (all with birth weights less than 1000 g). CONCLUSIONS: A significant proportion of patients with very low birth weights (mostly less than 1000 g) have large osmolal gaps and/or an MsOsm greater than 300 mmol/kg during the first week of life. The relationship between increased MsOsm in infants with very low birth weights and effective osmolality requires further study. Therapeutic intervention based solely on elevated MsOsm is ill advised.

Apgar Score↗
PubMed1992

[Eosinophilia and ascites as an expression of a subserous form of eosinophilic gastroenteritis].

Clinical and biological features are discussed on a 50 years old female, who suffered a peritonitis with eosinophilic ascites, together with a bilateral pleural effusion with the same cytologic findings, developing in the course of an hypereosinophilia. The clinical situations in which eosinophilic ascites is associated with blood hypereosinophilia are reviewed. The histopathological findings in this case support the diagnosis of eosinophilic gastroenteritis of subserous type.

Ascites↗
PubMed1991

Laser bronchoscopy.

Explore the source record for details and available documents.

Bronchial Neoplasms↗
PubMed1991

Endoscopic laser surgery. A single-center comprehensive experience.

A retrospective review of endoscopic procedures using the Nd:YAG laser was carried out for patients treated between October 1985 and March 1989. During this 42-month period 165 procedures were performed on 100 patients. The study encompasses a unique period of time in this center, as it includes the initial application, and finally, the time when its use became routine. Indications for laser surgery included the treatment of tumors, bleeding, benign strictures, arterial occlusions, and hemorrhoids. Nd:YAG laser was found to be effective in the treatment of these lesions. The overall success rate was 81 per cent. Patients who are poor surgical candidates would especially benefit from this therapeutic alternative.

Aged↗
PubMed1990

Early developmental exposure to benzodiazepine ligands alters brain 31P-NMR spectra in young adult rats.

Alterations in brain high energy phosphate compounds, using 31P-NMR (nuclear magnetic resonance) spectroscopy, were measured in vivo in young adult (3-4 months) rats following prenatal exposure to ligands acting specifically at benzodiazepine (BDZ) binding sites. The exposure induced a decrease in intracellular pH that indicated a predominant interaction of the drugs in utero with central-type BDZ receptor sites. Late gestational exposure to BDZ ligands also induced changes in brain phosphocreatine (PCr) utilization. Exposure to the lowest dose of DZ (1.0 mg/kg) but not the higher dose (2.5 mg/kg) induced a significant change in PCr utilization. Exposure to the central-type BDZ receptor antagonist RO15-1788 alone clearly altered PCr utilization in adult offspring, and DZ (2.5 mg/kg) when administered concurrently was not able to prevent this effect. Though exposure to a peripheral-type ligand (PK11195) had no effect by itself, it converted the effect of the high dose of DZ to that of the low dose. Together, these results indicate an interaction during development between the central and peripheral-type BDZ binding sites on organization and/or regulation of cellular energy metabolism. Normalized ATP levels were not changed by any prenatal treatment indicating adequate buffering of intracellular ATP by phosphocreatine. The dopaminergic antagonist haloperidol did not alter intracellular pH or any index of phosphate metabolism indicating a selective receptor mediated role for BDZ ligands in influences on the long term organization of intracellular phosphate metabolism.

Animals↗
PubMed1990

[Gastroenteritis with eosinophilia caused by Giardia lamblia].

A case of gastroenteritis due to Giardia lamblia with severe dehydration and complicated with arterial thrombosis, accompanied by eosinophilia and increased serum IgE levels, is presented. The relationship between Giardia and eosinophilia and allergic manifestations is discussed as well as its pathogenesis.

Acute Kidney Injury↗