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Biomedical subjects

A Alarcón

Publications and source records attributed to A Alarcón.

31 records · Page 2Linked to original sources
PubMed1995

[Compliance with nasal continuous positive airway pressure (CPAP) treatment in sleep apnea-hypopnea syndrome].

Ever since Sullivan introduced nighttime nasal continuous pressure on the upper airway (CPAP) in 1981 it has been the standard treatment for sleep-hypopnea syndrome (SAHS). However, CPAP is carried out at great expense and is not tolerated by all patients. Moreover, its efficacy is dependent on the degree of compliance. In this study we set out to analyze the degree of compliance with CPAP over the first 3 months of treatment in a group of 142 consecutive patients with moderate to severe SAHS (apnea-hypopnea index: 48.9 +/- 20). Diagnosis and measurement of the level of CPAP needed (9.6 +/- 2.5 cm H2O) were based on polysomnography. Eighteen (13%) patients did not return for follow-up evaluation. In the remaining 124 patients (age 54 +/- 11 years) compliance with treatment was evaluated by way of a sleep diary in which the patient recorded the hours CPAP was used at night; this record was compared with readings from the CPAP generator's counter. All subjects were asked about their degree of sleepiness before treatment by way of a standard questionnaire. Although most patients reported regular use of CPAP in diaries, only about 60% actually used it for longer than a mean 4.5 hours daily. The most compliant patients could not be differentiated from the least compliant with respect to degree of initial sleepiness, apnea-hypopnea-per-hour index or level of CPAP required.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Adequacy of prescribing nasal continuous positive airway pressure therapy for the sleep apnoea/hypopnoea syndrome on the basis of night time respiratory recording variables.

BACKGROUND: The increased demand of full polysomnographic studies, not only for diagnostic purposes but also for continuous positive airway pressure (CPAP) titration, has produced long waiting lists. Simpler methods are therefore needed to avoid having to refer all patients for full polysomnography. The hypothesis that CPAP therapy for the sleep apnoea/hypopnoea syndrome (SAHS) can be performed exclusively on the basis of recording night time respiratory variables was tested. METHODS: The level of CPAP in a group of 41 patients (three women) of mean (SD) age 52 (10) years, body mass index 31.5 (4.4) kg/m2, and apnoea/hypopnoea index (AHI) 53(16) events/hour was measured. During a two week period CPAP titration was performed in a random order in two settings: (1) in the sleep laboratory using full polysomnography; and (2) in the respiratory ward using equipment which continuously recorded and displayed pulse oximetry, airflow, chest and abdominal motion, and body position. The level of CPAP was increased progressively until apnoea, hypopnoea, snoring, and thoraco-abdominal paradox disappeared. RESULTS: No differences in CPAP levels (9.34(2.2) versus 9.68 (2.1) cm H2O) were found between full polysomnography and night time respiratory recordings. The accuracy of the measurement of both procedures showed good agreement. Only one patient showed a significant difference in CPAP level requirements between the two methods. CONCLUSIONS: Night time respiratory recording is sufficient to permit a reasonable choice of CPAP levels to abolish all the respiratory disturbances in most of the patients studied.

Female↗
PubMed1994

Long-term evolution and growth patterns in a family with Bartter's syndrome.

The five-year evolution of three siblings of a sibship affected by a combined potassium and magnesium wasting abnormality associated with hypocalciuria is presented. Fractional distal chloride reabsorption was low. A number of therapeutic measures were attempted with partial or no success. Consequently, patients were kept on oral potassium and magnesium supplementation only. Special attention was paid to nutritional status. Although the three girls maintained a plasma potassium range of 2.6 to 3 meq/l, sexual and mental maturation were not delayed. Growth remained within the lower limits of normality. Considering the poor results obtained from treatment and the side-effects, we conclude that this long-term approach is sound, at least, in less severe cases of Bartter's syndrome.

Bartter Syndrome↗
PubMed1993

Aerosolised ribavirin in patients with advanced cryptogenic fibrosing alveolitis: a pilot study.

BACKGROUND: A report has recently been published concerning a patient with a cryptogenic fibrosing alveolitis who showed a striking improvement after being treated with the antiviral drug ribavirin (tribavirin, Virazid). The objective of this study was to further evaluate, in an open trial, the efficacy of rivabirin in cryptogenic fibrosing alveolitis. METHODS: Ten patients (eight women) with advanced cryptogenic fibrosing alveolitis received aerosolised ribavirin (6 g/day for 15 days). Chest radiographs, lung function, and severity of dyspnoea were evaluated before and after two weeks of rivabirin treatment and also at three and 12 months. RESULTS: No differences in radiographs, lung function impairment, or severity of dyspnoea were found after treatment. No side effects were detected. CONCLUSIONS: Administration of high doses of aerosolised ribavirin has no beneficial effects in patients with advanced cryptogenic fibrosing alveolitis.

Aerosols↗
PubMed1990

Multicenter prospective study of treatment of Brucella melitensis brucellosis with doxycycline for 6 weeks plus streptomycin for 2 weeks.

The effectiveness of treating human brucellosis caused by Brucella melitensis with a 6-week course of doxcycline plus streptomycin for 2 of those weeks was analyzed by a multicenter prospective study of 139 patients. Subjects with central nervous system involvement, endocarditis, or spondylitis were excluded from the study. All but 5 of the 139 patients completed the full treatment schedule and became afebrile in the first week of therapy. Four patients suffered relapses during the follow-up period. Of the five patients who did not complete the treatment, two left because of adverse secondary effects (1.4%), another two left for noncomplicance with the treatment (1.4%), and the remaining patient was considered a therapeutic failure because his symptoms persisted after the first week of therapy (0.7%). We concluded that the combination of doxycycline and streptomycin is an effective treatment for the types of brucellosis included in our study.

Adolescent↗
PubMed1989

Chronic haemodialysis and personality.

UNLABELLED: The object of this study was to detect the influence of time under treatment on haemodialysis on the personality. The samples are a group on haemodialysis (EXT, n = 62) and a control group (CON, n = 33). The haemodialysis patients were grouped by years under treatment (EX1 less than 4 years, and EX2 greater than 4 years). To study personality variables, the Eysenck Personality Inventory test was used. The results showed, using t test, significant differences on neuroticism (N), extraversion (E) and lie or dissimulation (L), between both experimental subgroups (N, p less than 0.01; E, p less than 0.05 and L, p less than 0.02) as well as between experimental and control groups (N, p less than 0.01; E, p less than 0.01 and L, p less than 0.001). On the experimental group (EXT) a high neuroticism (mean = 73.1) level was observed associated with a low level of extraversion (mean = 41.8) and lie or dissimulation (mean = 29.9). According to the observed results, the length of time on haemodialysis affects the groups in a different, significant way. In the EX2 it is observed that the scores decrease on the three personality dimensions, their differences being significant. CONCLUSIONS: This chronic illness places patients first on a very high level of neuroticism, as a confrontation to the stress provoked by their situation. Following this, due to the patients' awareness of their own chronic state, the level of neuroticism decreases, their high level of introversion and the absence of lie as a possible defense mechanism of denial facing their hard reality being more significant.

Adaptation, Psychological↗
PubMed1989

[Inflammatory pseudotumor of the liver].

Certain rare, reactive, non-neoplastic processes are defined under the term inflammatory pseudotumor, which is constituted by the proliferation of connective tissue and chronic inflammatory infiltrate of circumscribed location. Its etiopathogenesis ins unknown, although it is thought to have a possible infectious nature. It has been described various organs, but location in the liver is exceptional. We present a new case of inflammatory pseudotumor of hepatic location, related to an "hour-glass" abscess adhered to diaphragm, this being the first case of this relation. We reviewed the literature concerning etiopathogenic, histopathologic, clinical and diagnostic aspects, and our findings are discussed.

Adult↗
PubMedDate not supplied

[Report of a case with skin lesions and calciphylaxis].

Calciphylaxis is an unusual complication of chronic renal failure associated with increased morbidity and mortality. This presentation is a clinical case describing a patient parathyreidectomized in 1997, followed by the condition was clinically suspected and then confirmed by skin biopsy. PTHi levels above 400 pg/ml together with scintigraphic images suggesting parathyroid nodules resulted in the decision to try a new surgical procedure, which yielded two nodules of thyroideal tissue. After the surgery and in spite of this pathology result, the patient recovered completely from her symptoms. This corroborates the theory that the etiology of calciphylaxis is multifactorial, acquiring special relevance the use of calcium-containing phosphathe binders (representing a high risk of hypercalcemia) in the treatment of Chronic Renal Disease.

Calciphylaxis↗
PubMedDate not supplied

[Valve replacement using an artificial ball prosthesis manufactured in Mexico].

This report documents our early experience with a cage ball valve manufactured in Mexico. Between May 1985 and March, 1986, 25 consecutive replacements have been performed in 23 patients, 14 underwent aortic valve replacement, 9 received a mitral valve, and 2 received both aortic and mitral valves. Their mean age was 32 years. Most of the patients had rheumatic heart disease. Their functional class prior to operation was as follows: six patients fell into class II, 15 into class III and 2 into class IV. One case died in the operative period. All patients have been followed for a mean period of 5 months. Late mortality has not occurred in any patient. Valve-related complications were not present. The post-operative NYHA functional class was as follows: seventeen (80%) fell into class I and five (20%) fell into class II. The actuarial survival rate 10 months after operation was 96.0%. Our study suggests that the cage ball valve has a good performance, the clinical results justify continuing investigation of this prosthesis.

Adult↗
PubMedDate not supplied

[Coronary thrombolysis in acute myocardial infarction. Initial experience with an intravenous thrombolytic agent].

Thirteen patients with less than 5 hours of the onset of symptoms of acute myocardial infarction underwent selective coronary angiography. Ten of them had angiographic signs of coronary thrombosis. In these ten patients 15 mgs of an acylated streptokinase-plasminogen complex (BRL 26921 Beecham Farmaceuticals) were administered intravenously. Total angiographic recanalization was observed in 7 patients. The coronary arteries involved were the left anterior descending in 4 cases and the right coronary artery in 3. In 8 out of the 10 patients significant diminution of injury pattern in EKG was registered, however in all of them the necrosis pattern supervened. Prolongation of the thrombin and thromboplastin times, as well as an important fibrinogen disminution were documented in all instances. There were not complications related to the administration of the drug. An increase of muscle enzimes was documented in all cases. The follow-up was uneventfull with excellent results in all the patients. This study proves that with IV trombolitic therapy coronary recanalization can be achieved in the mayority of the patients; however there is no question that myocardial infarction finally ocurred. We speculate about the possibility of avoiding infarction by the administration of the drug within the first hour after the onset of the symptoms.

Adult↗