Search PubMed⌕ Search

Biomedical subjects

R Moreno

Publications and source records attributed to R Moreno.

At least 127 records · Page 7Linked to original sources
PubMed1997

[Undergraduate curriculum reform at the Pontifical Catholic University Medical School: aims, methodology and advance status].

The Medical School of the Pontifical Catholic University is devoted to a reform process aiming to adequate undergraduate training to scientific, technological, cultural and social changes in medical practice in Chile and to incorporate novel teaching methodology. One of the main modifications is the change of the resulting professional from "a general physician capable of resolving most medical problems of rural or urban populations" to "a physician with a solid general training but qualified for a subsequent specialization". This requires curricular flexibility to obtain different professional profiles. Other important changes are a reduction in curricular contents and their vertical and horizontal integration, modernization of teaching methodologies with the incorporation of computing techniques and problem oriented teaching and the incorporation of new subjects such as molecular biology, clinical genetics, health economics. To achieve these objectives, a semi-flexible curriculum was devised, the curricular mesh has been modified extensively, an outpatient and a nine months elective internship were added. Most modifications have been implemented, remaining changes in 4th and 5th years. These changes required a reorganisation of academic structure, the use of new selection, training and perfecting criteria for teachers, better salaries for outstanding professors and improvement of teaching infrastructure. This reform must be seen as a medium term integral change in the context of an integral academic development plan.

Chile↗
PubMed1996

Substantial outgassing of CO from comet Hale-Bopp at large heliocentric distance.

When comet C/1995 O1 (Hale-Boop) was discovered, at a distance of seven astronomical units from the sun, it was more than one hundred times brighter than comet Halley at the same distance. A comet's brightness is derived from the reflection of sunlight from dust grains driven away from the nucleus by the sublimation of volatile ices. Near the sun, sublimation of water ice (a main constituent of comet nuclei) is the source of cometary activity; but at its current heliocentric distance, Hale-Boop is too cold for this process to operate. Other comets have shown activity at large distances, and in the case of comet Schwassmann-Wachmann 1, carbon monoxide has been detected in quantities sufficient to generate its observed coma. Here we report the detection of CO emission from Hale-Boop, at levels indicating a very large rate of outgassing. Several other volatile species were searched for, but not detected. Sublimation of CO therefore appears to be responsible for the present activity of this comet, and we anticipate that future observations will reveal the onset of sublimation of other volatile species as the comet continues its present journey towards the sun.

Carbon Monoxide↗
PubMed1996

Clinical experience with cotransplantation of peripheral nerve and adrenal medulla in patients with Parkinson's disease.

Coimplants of adrenal medulla (AM) and peripheral nerve (PN) in animal models of Parkinson's disease (PD) have shown that AM cells survive longer, tend to show neuronal phenotype, and enhance sprouting of host fibers. Since 1987, our implants of perfused AM and fetal ventral mesencephalon (FVM) in PD patients have achieved varying degrees of clinical improvement. If the donor tissue determines the improvement, different types of implants should result in qualitatively and quantitatively different degrees of improvement. The purpose of this study is to determine whether or not the clinical course, improvement slope, and reduction of medication observed in PD patients who undergo tissue transplantation (Tx) depend on the donor tissue type. In a pilot study, four grade IV-V PD patients received implants of precoincubated autologous AM and intercostal nerve in the caudate nucleus (open surgery). Clinical assessment was based on international scales (UPD) as reported for Tx of FVM and perfused AM. There were no systemic or neurologic complications. Four years post-Tx, longer On phases and improved PD symptoms (ADL and motor-UPD) in On and Off persist in four cases, with reduced dyskinesias. Progress appears to be stepwise, starting within weeks of Tx (similar to AM and sooner than our FVM implants), followed by a period of stability and, after a second wave of improvement 12-18 months post-Tx (similar to FVM implants), continues to date. L-dopa medication has been reduced by more than 60% and dopamine agonist use has not resumed. We conclude that our recipients continue to be clinically better than prior to Tx. The course of recovery after co-Tx of AM and PN differs from that of FVM or AM implants. This fact may be related to the etiological factors that produce the improvement.

Adrenal Medulla↗
PubMed1996

[Resistance of Mycobacterium tuberculosis in the province of Castellón].

We conduced a cross-sectional study to determine the prevalence of resistant mycobacteria in our setting. All patients in whom M. tuberculosis had been isolated in cultures of clinical samples (119) between January 1992 and December 1993 took part in the study. Canetti's method of percentages was used for the study of sensitivity to the following drugs: isocyanide, rifampicin, streptomycin, ethambutol and para-aminosalicylic acid. Overall resistance of M. tuberculosis was 9.24%. Specifically, we found resistance to isocyanide in 5.9%, to streptomycin in 4.20%, to rifampicin in 5.04% and to ethambutol in 1.68%. Resistance was primary in 7% and secondary in 21.05%; 2% showed primary resistance to isocyanide, 1% to isocyanide and rifampicin, 2% to streptomycin, 1% to ethambutol and 1% to streptomycin and rifampicin. These resistance indices are in keeping with those published for other areas of Spain.

Adolescent↗
PubMed1996

Angina bullosa hemorrhagica.

Angina bullosa hemorrhagica is characterized by acute blood blisters, mainly on the soft palate. Elderly patients are usually affected and lesions heal spontaneously without scarring. The pathogenesis is unknown, although it may be a multifactorial phenomenon. Trauma seems to be the major provoking factor and long term use of steroid inhalers has also been implicated in the disease. No underlying hematologic or immunopathogenic disorder has been found. Treatment is symptomatic. We present a 67-year-old patient with recurrent oral blood blisters which were diagnosed as angina bullosa hemorrhagica. Trauma by dental injections and use of steroid inhalers were identified as etiologic factors in this case. Erosions healed with a week. Although this is a benign condition, it may result in acute airway obstruction. Recognition is, therefore, of great importance for dermatologists.

Aged↗
PubMed1996

[Bradycardia and asystolia secondary to epileptic crisis. Report of a case].

We report the case of a 21 year old man with bradycardia and asystolia after a seizure. No cardiac disease could be demonstrated, but electroencephalography after sleep deprivation showed the presence of a temporal irritative focus. The importance of differential diagnosis between cardiogenic syncope and loss of consciousness due to epilepsy is discussed.

Adult↗
PubMed1996

[Effect of the treatment with amlodipine on left ventricular hypertrophy in hypertensive patients].

BACKGROUND: Left ventricular hypertrophy (LVH) is one of the physiopathological effects of hypertension and one of the main risk factors for sudden death, myocardial infarction and congestive heart failure. Drugs to treat hypertension must not only reduce blood pressure, but also modify the facts which lead to ventricular hypertrophy. This study has been designed to assess the effect of amlodipine, a calcium-antagonist, on LVH in hypertensive patients. METHODS: 20 hypertensive patients (mild to moderate, both sexes, mean age 45.0 yr) were included in a single-blind study. After an initial, four weeks placebo period, active treatment was given (amlodipine 5 mg a day). Dose titration was made after 4-8 weeks to 10 mg a day if necessary and continued until the end of the study. Systolic (SBP) and diastolic blood pressure (DBP), as well as pulse rate (PR) and adverse events were recorded at every visit. Blood and urine analysis, catecholamine, plasmatic renin activity and Mode M echocardiography were made at the beginning and the end of the study. RESULTS: Only one patient was excluded. SBP and DBP showed a significantly fall (p < 0.001). In 80% of patients DBP fell under 90 mm Hg. Every echocardiographic parameter, but left ventricular diastolic dimension, showed significantly reductions at the end of the study: septum thickness (p = 0.001), posterior wall thickness (p = 0.001), left ventricular systolic dimension (p = 0.014), wall relative thickness (p = 0.015), shortening fraction (p = 0.009), left ventricular mass (p = 0.001) and corrected left ventricular mass (p = 0.001). Blood parameters did not modify. CONCLUSIONS: Amlodipine has a beneficial effect on LVH and also is an effective and safe drug to treat mild to moderate hypertension.

Amlodipine↗
PubMed1996

[Management of patients with severe pneumonia in mechanical ventilation: usefulness of bronchoalveolar lavage].

UNLABELLED: Bacterial pneumonia is a frequent complication in patients requiring mechanical ventilation (9-21%) and carries a significant mortality. The optimal management of these patients remains controversial. Some investigators have advocated invasive diagnostic testing using bronchoscopic techniques. AIM: To asses the diagnostic value of bronchoalveolar lavage (BAL) in patients with suspicion of bacterial pneumonia in mechanical ventilation. PATIENTS: We evaluated 73 community-acquired pneumonia and 94 nosocomial pneumonia in critically ill and mechanically ventilated patients. RESULTS: The mortality was 50% (82 patients) and the principal death's cause was pulmonary sepsis (90%). 157 subjects received antibiotics before the microbiologic exam (94%) and 30 patients had multiple organ failure (MOF). Seventy of 167 BAL culture samples demonstrated microbial growth of > 10(4) cfu/ml (sensitivity: 41.9%). BAL culture samples isolated gram-positive cocci in 27 cases (39%), aerobic gram-negative bacilli in 39 cases (57%) and P carinii in 3 cases (4%). Correlation between BAL culture and hemocultive results was very insignificant. Prognosis of community-acquired pneumonia and nosocomial pneumonia were very bad in both cases. Mortality of patients with MOF (73%) was higher than patients without MOF (44.8%), (p < 0.01). Mortality was similar in patients with BAL culture positive (48.6%) and negative (49.5%). The mortality rate of severe pneumonia in MV was very elevated and the BAL culture results didn't affect significantly the survival.

Adolescent↗
PubMed1995

[Corynebacterium pseudotuberculosis adenitis in a shepherd].

Corynebacterium pseudotuberculosis causes suppurative lymphadenitis in sheep and other domestic animals. Human infection has been reported in few instances. We report on a case of Corynebacterium pseudotuberculosis lymphadenitis in a human being. A 34-years old previously healthy shepherd was attended for presenting a painful lymph node in right groin with one year of evolution. Cultures of an aspirate and ganglionar tissue yielded growth of Corynebacterium pseudotuberculosis in pure culture. Histological examination of the excised lymph node showed a suppurative granulomatous lymphadenitis with areas of necrosis in which there were clusters of bacillary organisms. After surgical excision and administration of erythromycin clinical signs disappeared without complications. We have carried out a review of the literature and we have found no case reported in Spain. Corynebacterium pseudotuberculosis lymphadenitis in human beings is a rare entity that principally affects persons in contact with animals, principally sheep. Most cases have been reported in Australia. In accordance with the reviewed literature this is the first time this disease is reported in Spain. Corynebacterium pseudotuberculosis infection should be considered in the differential diagnosis of localized granulomatous lymphadenitis.

Adult↗
PubMed1995

Chemical and thermal response of Jupiter's atmosphere following the impact of comet Shoemaker-Levy 9.

In July 1994, the collisions of the fragments of comet Shoemaker-Levy 9 with Jupiter resulted in dramatic changes in the planet's atmosphere. Observations of the events suggest that the composition and thermal properties of the atmosphere were considerably modified at the impact sites, with the changes persisting for times lasting from minutes to weeks (see, for example, refs 1-4). Here we report observations of the impact sites at millimetre wave-lengths, which reveal strong emission lines associated with carbon monoxide, carbonyl sulphide and carbon monosulphide. The abundance of carbon monoxide in the jovian atmosphere is normally very low; carbonyl sulphide and carbon monosulphide, on the other hand, have not hitherto been detected. We find that the largest fragments (G and K) each produced approximately 10(14) g of carbon monoxide, 3 x 10(12) g of carbonyl sulphide and 3 x 10(11) g of carbon monosulphide, most probably by shock-induced chemical reactions. Our observations also place firm constraints on the thermal response of Jupiter's stratosphere to the impacts.

Atmosphere↗
PubMed1995

Pityriasis rubra pilaris and human immunodeficiency virus infection.

Recently, the occurrence of pityriasis rubra pilaris (PRP) has been reported in patients with HIV infection. It presents different clinical features, and has a poorer prognosis, than the classical adult type of PRP. We report the occurrence of severe PRP in an HIV-infected patient, and review the previously reported cases of this association. We propose the designation of a new category of PRP (type 6), characterized by the presence of HIV infection, usually without immunosuppression, a poor prognosis and response to treatment, and the development of nodulocystic and lichen spinulosus lesions.

Adult↗