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Biomedical subjects

T Grau

Publications and source records attributed to T Grau.

At least 37 records · Page 2Linked to original sources
PubMed1993

[Ultrastructural studies of the ileum neobladder].

Four patients had cold biopsies of the ileal mucosa 15-40 months after bladder substitution with an ileal neobladder. We used electron optical systems encompassing scanning electron microscopy and transmission electron microscopy for ultrastructural evaluation of the specimen. The changes observed did not vary markedly from patient to patient. In all biopsies the number of normal intestinal mucosa cells as well as mitochondrial density and number of microvilli was significantly reduced. In contrast the density of goblet cells was similar to that found in normal ileal tissue. These findings confirm the clinical observation that, on long-term follow-up, patients with an ileal neobladder show a decrease in urinary resorption via the ileal mucosa, whereas mucus secretion tends to be constant.

Biopsy↗
PubMed1983

Study on the protection of CDP-choline against nicotine intoxication.

Cytidine diphosphate choline (CDP-choline, citicoline, Somazina) was orally administered to a group of mice at a dose of 1 g/kg for 4 days. Simultaneously, another group of mice were treated under similar conditions with 0.25% agar suspension. Then, animals were distributed into subgroups of 10 mice each and intravenous increasing doses of nicotine bitartrate were administered. By comparing the toxicity induced by nicotine in the animals receiving CDP-choline with that in animals receiving agar solution, a remarkable difference of the LD50 was observed between both groups.

Animals↗
PubMed1983

CDP-choline: acute toxicity study.

The acute toxicity of a single dose of cytidine diphosphate choline (CDP-choline, citicoline, Somazina) by different administration routes in mice and rats has been studied. LD50 values were determined according to the cumulative method by Reed-Muench for mortality rate, and Pizzi's method for calculation of standard error.

Administration, Oral↗
PubMed1983

Study of subacute toxicity of CDP-choline after 30 days of oral administration to rats.

Two groups of rats were administered by oral route doses of 100 and 150 mg/kg, respectively, of cytidine diphosphate choline (CDP-choline citicoline, Somazina), daily during 30 days. At the end of the test, animals were killed and necropsied, evaluating the urinary, haematological, serum biochemistry and histopathological parameters. The study did not reveal any signs of toxicity.

Administration, Oral↗
PubMed1983

CDP-choline: 6-month study on toxicity in dogs.

A single oral dose of 1.5 g/kg cytidine diphosphate choline (CDP-choline, citicoline, Somazina) was administered to 6 Beagle dogs daily for 6 months. After treatment period, treated animals as well as control animals were sacrificed and assessment of urinalysis, blood analysis and histopathological studies were made. Results were found within normal ranges--involving slight changes due to individual variability. It can therefore be concluded that CDP-choline does not cause any toxic effects under the chosen experimental conditions.

Animals↗
PubMed1977

Amitriptyline plasma levels and clinical response in primary depression.

Sixteen patients with primary depression were treated for 4 wk with amitriptyline. After clinical diagnoses were determined, patients entered a double-blind protocol (amitriptyline or placebo) and their clinical status was determined with the Hamilton Depression Rating Scale by raters blind to the drug type, its dosage and plasma levels. Amitriptyline (AT) and nortriptyline (NT) plasma levels were assayed twice weekly by gas chromatography-mass spectrometry. In the 16 patients, a negative correlation between the Hamilton Score and the mean total tricyclic level (p less than 0.01), as well as with individual plasma levels, was found at the end of the treatment period. When the group was divided into clinical responders and nonresponders, the mean total tricyclic (AT + NT) levels discriminated the two groups by day 12 (p less than 0.001) as well as at the end of the protocol (day 26, 88% of the patients were classified correctly if an arbitrary level of 200 ng/ml total tricyclic plasma level was chosen). These results strongly suggest the presence of a positive correlation between plasma levels and clinical improvement in patients with primary depression.

Adult↗
PubMedDate not supplied

Ultrasound imaging of the thoracic epidural space.

BACKGROUND AND OBJECTIVES: In thoracic epidural anesthesia, the "loss of resistance" technique is the standard technique for the identification of the epidural space (EDS), the feedback to the operator is often solely tactile. Our aim was to establish ultrasonography for the prepuncture demonstration of the anatomic structures surrounding the thoracic EDS and to evaluate its precision and imaging quality. METHODS: We examined 20 volunteers. In each participant, the extradural space and the neighboring anatomic landmarks in the intervertebral space Th 5-6 were identified using 2 imaging techniques: magnetic resonance imaging (MRI) and ultrasonography. We compared corresponding images regarding distance measurements and the visibility of anatomic landmarks. RESULTS: The capacity of ultrasound imaging (US) to depict the thoracic EDS was limited. Due to the better overview, MR images were easier to interpret. However, US proved to be of better value than MRI in the depiction of the dura mater. All important landmarks for the puncture of the thoracic EDS could be identified with both techniques. The overall correlation was satisfactory. US depicted the different structures of the thoracic EDS with an acceptable precision (confidence interval, 4.6 to 8.7 mm). CONCLUSIONS: US showed good correlation with MRI, which is a standard imaging technique for the depiction of the spine. We anticipate that prepuncture ultrasonography may facilitate thoracic epidural anesthesia by needle placement.

Adult↗
PubMedDate not supplied

Early enteral nutrition in critically ill patients with a high-protein diet enriched with arginine, fiber, and antioxidants compared with a standard high-protein diet. The effect on nosocomial infections and outcome.

BACKGROUND: This study was designed to evaluate the effects of a high-protein formula enriched with arginine, fiber, and antioxidants compared with a standard high-protein formula in early enteral nutrition in critically ill patients. METHODS: For this study, 220 patients were enrolled in a prospective, multicenter, single-blind, randomized trial in 15 Spanish intensive care units (ICUs). The primary end-points were the incidence density rates of nosocomial infections, ICU and hospital length of stay, ICU and in-hospital mortality, and mortality at 6-month follow-up. RESULTS: The patients in the control and study groups had similar baseline characteristics. The study group had a lower incidence of catheter-related sepsis (0.4 episodes/1000 ICU days) than the control group (5.5 episodes/1000 ICU days), with a relative risk (RR) of 0.07 (95% confidence interval [CI] 0.01 to 0.54, p < .001). There were no differences in the incidence of ventilator-associated pneumonia, surgical infection, bacteremia, or urinary tract infections between the 2 groups. ICU mortality (16% in the study group versus 21% in the control group; RR 1.5, CI 95% 0.7 to 2.9) and in-hospital mortality (21% in the study group versus 30% in the control group; RR 1.6, CI 95% 0.9 to 3) were similar without differences in survival at 6-month follow-up (75% in the study group versus 68% in the control group, p = .15). Patients in the study group who were treated for 2 or more days showed a strong trend for better survival at 6-month follow-up (76% in the study group versus 67% in the control group, p = .06). Medical patients treated with the study diet had better survival than medical patients in the control group (76% in the study group versus 59% in the control group, p < .05). CONCLUSIONS: Critically ill patients fed a high-protein diet enriched with arginine, fiber, and antioxidants had a significantly lower catheter-related sepsis rate than patients fed a standard high-protein diet. There were no differences in mortality or ICU and hospital length of stay. The subgroup of patients fed the study diet for >2 days showed a trend toward decreased mortality.

Adult↗
PubMedDate not supplied

[Randomized study of two different fat emulsions in total parenteral nutrition of malnourished surgical patients;effect of infectious morbidity and mortality].

GOAL: Lipid infusions of a physical mixture of medium-chain triglycerides and long-chain triglycerides (MCT/LCT) used in peri-operative total parenteral nutrition (TPN) have a lower immunosuppressive effect in laboratory studies than emulsions containing only long-chain triglycerides (LCT). The purpose of the present study was to compare the incidence of nosocomial infections and the in-hospital mortality of severely undernourished surgical patients treated with TPN using an MCT/LCT lipid emulsion or with an LCT mixture, administered under a randomized, double blind protocol. PATIENTS AND METHODS: A total of 72 severely undernourished patients subjected to planned or emergency laparotomy were prospectively recruited and stratified by the presence or absence of cancer, on admission to the departments of General Surgery and Intensive Care Medicine at a teaching hospital. The main outcome was the incidence of intra-hospital nosocomial infection and the secondary outcome was mortality. RESULTS: The patients in the study group (MCT/LCT) and the control group (LCT) shared similar characteristics. The patients in the MCT/LCT group had a significantly lower incidence of intra- abdominal abscesses (2/26) than those in the LCT group (10/31) (p < 0.05; RR 0.18; CI 95%; 0.03-0.89). There were no significant differences in the incidence of other infections. Nor was there a difference between the two groups in terms of the intra-hospital mortality (4/26 versus 11/31). In the stratified analysis, patients without cancer treated with MCT/LCT presented significantly fewer intra-abdominal abscesses (2/14) than those with LCT (5/8) (p < 0.05; RR 0.1; CI 95%; 0.01-0.79) and a significantly lower mortality (2/14 versus 5/8; p < 0.05; RR 0.1; CI 95%; 0.01-0.79). CONCLUSIONS: Lipid infusions of MCT/LCT used in peri-operative TPN protect severely undernourished surgical patients against the onset of intra-abdominal abscesses when compared with LCT infusions. Patients without cancer may obtain more benefit from the use of these mixtures.

Aged↗
PubMedDate not supplied

[Evaluation of palatability of two special oral diets for institutionalized elderly diabetics, Glucerna SR vs Resource Diabet].

OBJECTIVES: To evaluate the organoleptic characteristics of two specific nutritional supplements for diabetes (Glucerna SR and Resource Suport) and compare them. SETTING: An evaluation was made of 456 patients with Type 2 diabetes (most of them receiving OADs or insulin) from 34 centers. They were non-smoking elderly patients (mean age 73 to (71-78) admitted to nursing homes or homes for the aged distributed all over the Spanish territory. INTERVENTIONS: Palatability was studied using a modified wine tasting scale assessing 6 parameters (appearance, smell, body, sweetness, aftertaste and taste) that were scored individually, with a total score ranging from 0 (most unfavorable) to 20 (most favorable). Each brand was evaluated in two flavors (vanilla and strawberry) according to a crossover, double-blind design. RESULTS: A total of 906 evaluable observations were made, and highly statistically significant differences favorable to Glucerna RS were found in all parameters considered both absolutely and relatively, exception for sweetness, for which statistical significance was not reached because it was relatively evaluated. No statistical differences were found between the two flavors (vanilla and strawberry). The only significant confusing factor found was age; the older the age, the more the differences were noted between the two brands. CONCLUSIONS: Glucerna SR has a better flavor than Resource Suport for institutionalized elderly diabetic patients.

Aged↗