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Biomedical subjects

R Sanchez

Publications and source records attributed to R Sanchez.

At least 163 records · Page 9Linked to original sources
PubMed1985

[Valve replacement associated with aorto-coronary bypass in ischemic mitral insufficiency].

26 cases of ischaemic mitral regurgitation (MR) were treated by combined surgery: mitral valve replacement (MVR) and coronary bypass grafting (CBG). This type of operation is not common (1.3 p. 100 of all operations) and is usually reserved for men (21 cases) of middle age (average 59 years). A half of the cases had suffered previous myocardial infarction (MI), an average 5 months before surgery (range 20 days to 2 years). The other half had severe angina or ECG changes of myocardial ischaemia. 23 patients were in Class IV (15 patients) or Class III (8 patients) of the NYHA classification. 6 of the cases required intraaortic balloon pumping. Mitral regurgitation was severe () in half of the cases with a raised pulmonary capillary (mean V wave = 52 mmHg) and systolic pulmonary artery pressures (mean = 47 mmHg: exceeding 60 mmHg in 7 cases). The coronary lesions were severe in 18 patients (12 cases of double and 6 of triple vessel disease including 2 cases of left main stem stenosis). Ruptured chordae were found in 11 cases and papillary muscle necrosis in 4 cases. Surgery comprised MVR with 12 bioprostheses and 14 mechanical prostheses. 33 CBG were performed (anterior wall: 15 cases, posterior wall: 11 cases). In addition, one tricuspid annuloplasty and 3 ventricular aneurysmectomies were carried out. The hospital mortality was 15.4 p. 100. The main causes of morbidity were low output states and postoperative MI (2 cases).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1985

[Influence of chlorhexidine on the flora of burns].

The effect of chlorhexidine baths on surface and in-depth colonization of burns was studied in 12 severely burned patients. 202 swabs and 202 biopsy specimens were cultured. Each patient was sampled before and after a daily chlorhexidine bath on several days. Subsequent to bathing, 41% of swabs became sterile and a 1.41 log10 reduction in the number of germs in biopsy specimens was observed. However, deep flora was unchanged in almost half of cases (43.3%) and was reduced by only 1 to 2 log10 in one-third of cases (35.3%). Chlorhexidine added to baths inhibited surface bacterial growth but had an inconsistent and limited effect on in-depth colonization.

Adolescent↗
PubMed1985

Facilitated blind intubation using a transtracheal guide wire.

A method of tracheal intubation facilitated by using a transtracheal guide-wire is illustrated by three selected case stories. In two cases, the patients were blindly intubated and in the third case, with epiglottitis, the aditus layngis could be identified only by use of the guidewire. Using a laryngoscope and Magill's forceps, intubation was in this case performed without complications. It is suggested that the method applied in cases of difficult intubation may reduce the rate of acute tracheostomies.

Adolescent↗
PubMed1985

[Nutritional and immunologic state of patients undergoing heart valve surgery].

A series of 60 consecutive patients treated by heart valve replacement surgery under extracorporeal circulation were reviewed. Poor nutrition was assessed in 28% of these cases, the cardiac index in these patients being significantly smaller than in operated patients with normal nutritional states (2.07 +/- 0.8 as against 2.46 +/- 0.7, p less than 0.01). Furthermore, 58% of those with poor nutrition presented postoperative complications: mediastinitis, wound infection, ventricular arrhythmias or secondary pulmonary infection. One death occurred in this group. Postoperative complications in patients with normal nutritional states developed in only 6% and there were no deaths. Duration of hospital stay was significantly longer in patients with poor nutrition (p less than 0.05). Apart from immunoglobulin levels, all immunologic parameters underwent postoperative modifications related to nutritional state. Physiopathologic hypotheses are proposed as well as a programme for increasing nutritional intake in patients in a precarious metabolic state which predisposes them to complications.

Adult↗
PubMed1984

Neuronal blockade with morphine. A hypothesis.

A patient with an apical lung tumour invading the brachial plexus (Pancoast's tumour) suffered from unbearable pain unmodified by daily treatment with morphine 180 mg subcutaneously. An interscalene brachial plexus block was performed using a solution containing 5 mg morphine hydrochloride in 10 ml isotonic saline. Complete analgesia was obtained after 20 minutes, an effect which lasted for the next 36 hours. Neuro-axonal transport of morphine to the spinal cord may be the explanation of the effect, an hypothesis which ought to be subjected to controlled trials.

Aged↗
PubMed1984

An alternative route for infecting armadillos with Mycobacterium leprae.

A nine-banded armadillo was inoculated with Mycobacterium leprae in both hind footpads. The animals were usually inoculated intravenously, or intradermally in the abdominal skin. Profuse multiplication of the bacilli occurred at the injection sites after more than two years. Eventually bacteraemia developed, and large numbers of the organisms were found in skin biopsies and in lymph nodes. There was limited dissemination of the bacteria into the spleen and the liver, and peripheral nerve invasion by the bacilli was also detected. M. leprae remained viable in the liver tissue, kept frozen at -80 degrees C for three years. This experimental system would be useful in testing the effects of certain immunological and chemotherapeutic agents against M. leprae by injecting them directly at the infection site.

Animals↗
PubMed1981

Sex related effects of nutritional supplementation during pregnancy on fetal growth.

Nutritional supplementation of low income women during pregnancy increased birth weight significantly only in the male offspring. No differences by sex were apparent in the amount of supplementation, length of gestation or maternal characteristics known to be associated with birth weight. Regression analysis revealed a significant supplementation by sex interaction. The fetal growth curve of the supplemented males was higher and roughly parallel to the curve of females, and showed an effect of supplementation prior to 35 weeks of gestation. These findings and those of other authors support the hypothesis that fetal growth of males towards the end of pregnancy is more rapid and hence more susceptible to adverse environmental influences than that of females. This is reflected in a reduction of the difference in birth weight in favor of males observed in well-nourished populations. It is postulated that male subjects therefore exhibit sensitivity to nutritional supplementation of their mothers during pregnancy.

Birth Weight↗
PubMed1981

Effects of apomorphine on the rabbit electroretinogram.

Experiments were conducted in both albino and pigmented rabbits to determine the effects of apomorphine on the electroretinogram (ERG). Injection of apomorphine (0.1 to 1.5 mg/kg) into the left carotid artery produced dose-related decreases in the b-wave, predominantly in the b2-wave amplitude, and also increases in the c-wave amplitude. No significant changes were observed in the a-wave amplitude or in the attendant latencies. The ERG changes apparently were not related to systemic drug effects. The effects of the drug were similar for both albino and pigmented rabbits. Apomorphine, a dopamine agonist, has the opposite effect on the b2-wave of the ERG when compared with the effect of chlorpromazine, a dopamine antagonist. Involvement of dopamine receptors is not unexpected, since the retina is rich in dopamine, especially in the inner plexiform layer.

Animals↗
PubMed1978

Experimental observations on short and long-term effects of arterial occlusion with Ivalon.

Ivalon sponge has proved to be a useful embolic material, particularly when long-term or permanent occlusions are desirable. It has been stated that Ivalon is well tolerated and that it produces little if any damage to the wall or periadventitial tissues of the embolized artery. Our study demonstrates definite evidence of inflammatory reaction in the wall of the embolized arteries; these changes were seen only in the acute phase and seem to be secondary to damage of the vessel wall by the plastic material. Permanent occlusion results with disappearance of the inflammatory changes at nine months postembolization.

Animals↗
PubMed1978

Pharmacodynamic interference between rifampicin and isoniazid.

This study includes 30 children below the age of 3 years, distributed in three groups of 10 children each. One group received 15 mg/kg/day of rifampicin (RAMP), the other received 15 mg/kg/day of isoniazid (INH) and the third received both drugs (RAMP + INH) at the same doses. Plasma levels of RAMP and INH were determined. At the same time, some hepatic function parameters were analyzed: bilirubin, transaminases, alkaline phosphatases and prothrombin. Plasma levels of INH administered alone show significantly higher levels on the 7th day with respect to the 1st day, thus demonstrating a marked tendency towards the accumulation of successive doses. Very significant differences exist between initial and final values of transaminases in the RAMP + INH group. There are no significant differences in the other two groups. These data suggest a hepatic overload when both drugs are simultaneously administered.

Alanine Transaminase↗