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R Morales

Publications and source records attributed to R Morales.

87 records · Page 5Linked to original sources
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[The search for clinical markers of abnormal hypercoagulable states among factors that trigger venous thromboembolic disease].

We proposed to search for markers of hypercoagulable states in function of age, sex or factors that trigger venous thromboembolic disease (VTD) in a group of patients so diagnosed. The following patient data were analyzed: age, sex and triggering factors of VTD categorized as associative-transient, permanent or unknown. In patients under age 55 years of age in whom the triggering factor of VTD was unknown, and in those who had a family and/or personal history of VTD, coagulability was assessed approximately three months after the episode of acute thrombosis and was repeated during follow-up. From April 1993 to July 1996 we saw 297 patients diagnosed of VTD and performed 187 coagulability tests (63%). Eighty-six were normal (46%) and 101 (54%) abnormal. No significant relations were found for age, sex or triggering factors and the results of follow-up coagulability testing. We conclude that factors known to trigger VTD are not the only ones relevant for indicating the need to order the assessment of coagulability, given that the presence of coagulopathy is not confined to patients with supposed clinical markers.

Biomarkers↗
PubMedDate not supplied

Dengue fever with thrombocytopenia: studies towards defining vulnerability of bleeding.

PURPOSE: To define the period of greater vulnerability of bleeding in patients with Dengue fever in reference to the onset of their constitutional symptoms and the laboratory abnormalities. PATIENTS AND METHODS: In a retrospective study we reviewed the records of all patients admitted to San Pablo Medical Center in 1991 with a diagnosis of Dengue Fever or Hemorrhagic Dengue. All patients with a platelet count of less than 125,000 were included for analysis. The exclusion criteria included the presence of systemic disorders which may influence the platelet count, and patients without documentation regarding the presence of constitutional symptoms suggestive of viral illness. RESULTS: A total of 101 patients were analyzed of which only 74 were included in the study. All patients had fever and chills; skin rash, asthenia and general malaise was seen in over 50% of patients. Over 70% of patients had recovery of their platelet count, and most had their maximal thrombocytopenia within the 5th day and 8th day from the onset of constitutional symptoms. Leukopenia was seen in over 70% of patients with its lowest level within the 5th and 8th day from the onset of the constitutional symptoms. Significantly prolonged partial thromboplastin time was seen in 11% of the patients. Proteinuria was seen in 22% of the patients, 38% of which had it within the first 4 days of the onset of constitutional symptoms and also noted on the 5th and 6th day. Alteration in liver enzymes were noted in 47% of patients, with a maximal severity distributed in all time frames. Hypoalbuminemia was present in 28% of the patients, of these 67% presented within the first 4 days from the onset of constitutional symptoms. The pulse rate was usually normal in spite of the patient's dehydration and fever. CONCLUSIONS: We identified three phases that define the sequence of events seen in the majority of patients with Dengue Fever and Thrombocytopenia. These are: 1. proteinuria and hypoalbuminemia; 2. maximal cytopenia; 3. bradycardia and liver enzyme elevation. We believe this information is useful in the management of patients with Dengue Fever and thrombocytopenia.

Adolescent↗
PubMedDate not supplied

[Synergism of midazolam and propofol in the induction of anesthesia].

INTRODUCTION: The purpose of this study was to determine the possible interaction of midazolam and propofol in the induction of anesthesia. METHODS: A double-blind study of 90 ASA I-II women undergoing elective general surgery and gynecology was performed. The patients were divided into three groups of 30 patients receiving midazolam, propofol and a combination of both as the anesthesia induction agent. As a test of anesthetic induction the response to the verbal order of opening their eyes was evaluated. The dose-response curves for each group were determined by a logistic regression procedure while isobolographic analysis compared the actions of both agents separately and together. RESULTS: The ED50 in the propofol group was 1.56 mg.kg-1 and that of the midazolam group was 0.24 mg.kg-1. In the midazolam-propofol group the ED50 of midazolam was reduced approximately a quarter (0.068 mg.kg-1) when associated to the half of the ED50 of propofol anteriorly obtained. Isobolographic analysis revealed that the conjunctive action of both drugs was synergic (p = 0.04). CONCLUSIONS: Propofol potentiates the action of midazolam in anesthetic induction. Although this synergism also reduces with the association of thiopental-midazolam, the mechanism of action is not demonstrated as the same. Thiopental increases the affinity of the benzodiazepines for the GABA complex receptors which has not been described for propofol.

Adult↗