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Biomedical subjects

S Rodriguez

Publications and source records attributed to S Rodriguez.

154 records · Page 9Linked to original sources
PubMedDate not supplied

Current practice of exercise stress testing among pediatric cardiology and pulmonology centers in the United States.

The objective of this study was to characterize current practice patterns for clinical exercise stress testing (EST) in children in the United States. We conducted a survey of 109 pediatric cardiology programs and 91 pediatric pulmonology programs at children's hospitals or university hospitals in the United States. A total of 115 programs from 88 hospitals responded (response rate, 58%). A higher percentage of cardiology programs (98.7%) have exercise laboratories compared with pulmonology programs (77.5%). Sixty-three percent of respondents have both a treadmill and a cycle ergometer. A larger proportion of respondents (76%) rely primarily or exclusively on treadmill, whereas a smaller number use cycle ergometer (24%). Sixty-seven percent of respondents reported that they include metabolic measurements in EST protocols. Respondents have varying minimum age criteria for EST, with 9% reporting < or = 4 years, 25% reporting 5 years, 31% reporting 6 years, 16% reporting 7 years, and 20% reporting > or =8 years. Programs using cycle ergometers tend to test children at a younger age and to measure metabolic parameters. Seventy-nine percent of respondents use Bruce and modified Bruce protocols. Institutional protocols are used by 14%. Ninety percent of respondents use technicians to perform EST and 8% use nurses, but 76% require physician presence during testing. The majority of respondents (57%) perform < 100 pediatric tests per year. There are wide variations in the current practice of EST among pediatric subspecialty programs in the United States. Treadmills are used more frequently than cycle ergometers, and Bruce and modified Bruce protocols are commonly used. Most survey respondents measure metabolic parameters during EST.

Adolescent↗
PubMedDate not supplied

Bacteremia caused by Enterobacter: 15 years of experience in a cancer hospital.

A total of 296 episodes of bacteremia due to Enterobacter occurred in 281 patients with cancer between 1972 and 1986. The majority of these episodes were caused by Enterobacter cloacae. Seventy-four percent of the patients developed their infection while in the hospital and 55% had received therapeutic antibiotics during the 10 days preceding the onset of the infection. Enterobacter bacteremia was associated with shock in 24% of the patients and with disseminated intravascular coagulation in only 3%. The overall rate of response to therapy was 79% and increased to 85% during the last 5-year period. Only five patients remained afebrile during their infection, but four of these five died. Only 37% of the patients with shock responded to therapy compared with 93% of the patients without shock. The rate of response to therapy was 86% among patients without pulmonary infection compared with only 53% among those with pulmonary infection. The response rate to therapy with a single antibiotic was 73% and that to therapy with two antibiotics was 85%. As single therapeutic agents aminoglycosides were less effective than beta-lactam agents.

Adolescent↗
PubMedDate not supplied

Culture shock--the road to TQM.

Total quality management thrusts the company that adopts this philosophy on a road which determines customers' needs and fine tunes each and every operation in the facility to meet those needs. Crawford Long Hospital at Emory University, Atlanta is traveling that road.

Georgia↗
PubMedDate not supplied

Postnephrectomy arteriovenous fistula.

A new case of postnephrectomy arteriovenous fistula is reported. This is an uncommon acquired complication of a common surgical procedure. Clinical features, diagnostic procedures, surgical treatment and results are analysed and discussed. In this case, a direct communication between the right renal artery and the inferior vena cava was found.

Arteriovenous Fistula↗
PubMedDate not supplied

Ulcerative colitis, autoimmune hemolytic anemia and rectovaginal fistula: report of a case.

A case of autoimmune hemolytic anemia associated with ulcerative colitis and rectovaginal fistula in a 27-year-old woman is reported. It appeared during the first episode of ulcerative colitis occurring in the immediate puerperium. Laboratory studies revealed a positive direct Coombs test with polyspecific sera and monospecific for IgG. Panagglutinins and cold agglutinins with titers under 1:50 were also demonstrated. Treatment with steroid therapy was sufficient for a swift and complete recovery of the patient, the direct Coombs test becoming negative six weeks after admission.

Adult↗
PubMedDate not supplied

[Biliary stenosis in patients treated with liver transplantation. Diagnostic approach].

Between April 1986 and August 1994, 393 orthotopic liver transplantation (OLT) have been performed at "12 de Octubre" Hospital. Among these ones we consider 274 OLT made in 223 adults and in 47 children (4 intraoperative deaths). The reconstruction of the biliary tract was performed with a choledocho-choledochostomy with T tube (CD-CD T) in 131 patients, a choledocho-choledochostomy without T tube or stent (CD-CD) in 75, a Roux-en-y-hepatico-jejunostomy (H-J) in 248, a hepatico-jejunostomy with stent (H-J St) in 13 and a choledocho-cholecisto-jejunostomy (CD-CC-J) in 3 patients. Thirthy six (13.3%) patients developed biliary complications (30 adults and 6 childrens). Fourteen (18.6%) occurred in CD-CD reconstruction and 13 (11.4%) in CD-CD T. The most common complications were leakage and stricture. Thirteen ERCP were performed in 12 patients (1 failed), all adults (CD-CD T: 3; CD-CD: 10). The main indication for ERCP was cholestasis and inability of non invasive methods ultrasound, scintigraphy and computerized tomography in determining the underlying etiology. ERCP was successful in all 12 patients: detecting strictures in 8, strictures + lithiasis in 1, stricture+lekage in 1 and leakage in 2. No complications were encountered after ERCP in our patients. ERCP is the method of choice in diagnosis of biliary complications in CD-CD biliary reconstruction.

Adult↗
PubMedDate not supplied

Effect of kangaroo care on sleep time for neonates.

PURPOSE: To determine the change in behavioral state and physiologic parameters due to Kangaroo Care (K Care). METHOD: A quasi-experimental design using a pretest-posttest with neonates serving as their own controls for 4 episodes of 1 hour each: Pre K Care, K Care and Post K Care. Twenty neonate-parent dyads participated. RespiTrace PT Non-invasive Monitoring system was used to record heart and respiratory rate and oxygen saturation. Behavioral state was derived from analyzing RespiTrace PT cardiorespiratory data as well as observation criteria. FINDINGS: There was a significant increase in sleep time for the neonates during K Care as compared to when they were not receiving K Care. The neonates exhibited less agitation, apnea, and bradycardia episodes and maintained stable oxygen saturation during K Care. CONCLUSION: K Care is safe even for very small neonates and is well tolerated. The stability of the preterm infants receiving K Care documents the need to incorporate it into standards of care.

Clinical Nursing Research↗
PubMedDate not supplied

Effect of hepatic disease on the pharmacokinetics and plasma protein binding of eprosartan.

STUDY OBJECTIVE: To evaluate the pharmacokinetics and plasma protein binding of eprosartan in hepatic disease. DESIGN: Single-dose, parallel-group study. SETTING: Oklahoma Foundation for Digestive Research, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma. PATIENTS: Eight healthy subjects with normal hepatic function and eight patients with hepatic disease. INTERVENTION: All subjects received a single oral dose of eprosartan 100 mg. MEASUREMENTS AND MAIN RESULTS: Eprosartan plasma concentrations were quantified by high-performance liquid chromatography; plasma protein binding was determined by ultrafiltration. Using analysis of variance, point estimates (PE) and 90% CIs were calculated. Total and unbound maximum concentrations and degree of plasma protein binding were similar for both groups. Total area under the plasma concentration-time curve (AUC0-t) was approximately 40% higher for the group with hepatic disease (PE 1.42, 90% CI 0.94-2.14). Similarly, unbound AUC0-t was approximately 50% higher (PE 1.53, 90% CI 0.98-2.39). CONCLUSION: Eprosartan was safe and well tolerated by both groups. Based on the increase in AUC in patients with hepatic disease compared with those with normal hepatic function, the dosage of eprosartan in patients with hepatic disease should be individualized based on tolerability and response.

Acrylates↗