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Biomedical subjects

A Carrillo

Publications and source records attributed to A Carrillo.

At least 37 records · Page 2Linked to original sources
PubMed1999

Surfactant treatment for acute respiratory distress syndrome.

OBJECTIVE: To determine prospectively the efficacy of surfactant in acute respiratory distress syndrome. STUDY DESIGN: Twenty patients, 1 month to 16 years of age, diagnosed with an acute pulmonary disease with severe hypoxaemia (PaO2/FiO2 < 100) (13 with systemic or pulmonary disease and seven with cardiac disease) were treated with one to six doses of 50-200 mg/kg of porcine surfactant administered directly into the trachea. The surfactant was considered to be effective when the PaO2/FiO2 improved by > 20%. RESULTS: After initial surfactant administration the PaO2/FiO2 increased significantly in patients with systemic or pulmonary disease from 68 to 111, and the oxygenation index (OI) diminished significantly from 36.9 to 27.1. The PaO2/FiO2 and OI did not improve in children with cardiac disease. The improvement of the patients who survived was greater than that of those who died. CONCLUSIONS: Surfactant moderately improves oxygenation in some children with severe acute respiratory distress syndrome secondary to pulmonary or systemic disease.

Adolescent↗
PubMed1999

Paediatric life support instructors courses in Spain. Spanish Paediatric and Neonatal Resuscitation Group.

Between October 1996 and February 1998 we have provided five PLS instructors courses for 127 physicians. The instructor course takes 20-24 h over in 3 days, with 20-36 students per course. Theory classes last 5 h and practical stations between 14 and 18 h. Theory classes include: types and organisation of paediatric courses, resuscitation material, methodology of education, didactic methods, and methods of evaluation. The practical classes include techniques of oral expression, resuscitation material, and methodology, and evaluation of basic life support, airway and ventilation, venous and intraosseous access, diagnosis and treatment of arrythmias, neonatal resuscitation and advanced resuscitation. At the end of the course the students perform an anonymous written evaluation of the course with scores between 1 (very bad), 2, 3, 4 and 5 (very good). Theoretical aspects practical classes, methodology, and organisation of the PLS instructors courses are considered satisfactory by the students. We conclude that PLS instructors courses are important for assuring the uniformity and quality of paediatric life support courses.

Cardiopulmonary Resuscitation↗
PubMed1998

HPV prevalence among Mexican women with neoplastic and normal cervixes.

Genital human papillomavirus (HPV) infection is causally linked to cervical cancer, yet little is known regarding HPV prevalence in cancerous and normal women in Mexico, a country with a high cervical cancer incidence. We studied 185 Mexican women among the patients attending gynecological outpatient clinics in four hospitals in Mexico City. Each woman had a Pap smear, a colposcopy, and, when necessary, a biopsy. HPVs were identified by a consensus-primer-based polymerase chain reaction (PCR) assay. HPV was detected in 87% of 69 cancers, 83% of 24 high-grade squamous intraepithelial lesions (HGSILs), 33% of 21 low-grade squamous intraepithelial lesions (LGSILs), and 17% of 71 normals. Twenty-one of the 32 HPV types tested were detected at least once. The ratio of high-risk:low-risk types was 87:6 in HGSILs and cancers, compared to 11:8 for LGSILs and normals. In invasive cancers, HPV types found at the highest frequency were, in descending order: HPV-16, -18, and -45, followed by -39, -59, and -58 with the same frequency. HPV-16 and related types were present in 52% of the cancer cases, as well as in 79% of HGSILs, and HPV-18 and related types were present in 36% of the cancers but in only 12.5% of the HGSILs. HPV-16 was predominant in squamous carcinomas, and HPV-18 and related types were predominant in adenosquamous carcinoma. Both biopsies and scrapes were tested for HPVs in 63 women, all of them with cervical neoplasia. Identical HPV results were obtained in 89% of the samples, but additional types were often identified in scrapes. HPV prevalence and type distribution in cervical cancer in Mexico was similar to the reported worldwide, as well as in other Latin American countries.

Carcinoma, Adenosquamous↗
PubMed1998

Jugular venous oxygen monitoring: a helpful technique in the early diagnosis of a traumatic carotid-cavernous sinus fistula.

This report describes the early diagnosis of a right traumatic carotid-cavernous sinus fistula (CCSF) in a patient with head injury manifested as an acute increase in right jugular venous oxygen saturation and with no ophthalmic clinical signs. High values of jugular venous oxygen saturation must be cautiously interpreted with the clinical examination and computed tomographic findings to establish an accurate diagnosis of hyperemia with or without a CCSF.

Adult↗
PubMed1998

Effects of exogenous recombinant human growth hormone on an animal model of suboptimal nutrition.

BACKGROUND: Nutritional dwarfing, a form of suboptimal nutrition, has been identified as a frequent cause of short stature and delayed sexual development in children. Retarded growth is an adaptive response to suboptimal nutrition. OBJECTIVE: To assess whether recombinant human growth hormone (rhGH) may promote growth during various levels of suboptimal nutrition. METHODS: Using a previously developed rat model of suboptimal nutrition, six groups of rats (six rats/group) were fed a balanced 1:1 carbohydrate:fat ratio diet for 4 weeks. Three of the groups were administered daily injections of rhGH (0.1 mg/100 g BW) subcutaneously in the back while the other three groups were kept as controls and were given similar dosages of normal saline solution (NSS). Restricted rats within each treatment group were pair fed 80 and 60% of the ad-libitum rats intake. Daily intake of the 80 and 60% fed groups were determined based on the intake of the ad-libitum fed groups. Serum IGF-I and insulin were determined after 4 weeks of dietary treatment by radioimmunoassay while IGFBP-3 was determined by an immunoradiometric assay. Body composition was assessed in all rats by carcass analysis. RESULTS: After 4 weeks, total weight gain and tail growth were higher (p < 0.05) in the rhGH treated group at 80 and 60% of-libitum energy intake. Serum levels of IGF-I and IGFBP-3 were higher (p < 0.05) in rhGH treated rats fed at 60% of ad-libitum. In comparison to the NSS groups, administration of rhGH in rats fed ad-libitum increased total body water. Energy restriction caused decreased fat percentage (p < 0.05) in both rhGH and NSS groups without differences among treated groups. CONCLUSION: These results suggest that the anabolic effects of rhGH may overcome mild to moderate energy restriction.

Animals↗
PubMed1998

Transpyloric enteral feeding in critically ill children.

BACKGROUND: Nutrition is important in childhood because the child has a lower energy reserve than the adult and a higher demand for calories because of ongoing growth. In this study, the utility of transpyloric enteral feeding (TEF) in critically ill children was evaluated. METHODS: A prospective, descriptive study was made in a pediatric intensive care unit of a tertiary pediatric center of 41 critically ill children, 30 after surgical procedures and 11 with nonsurgical illness, aged 8 days to 12 years, who received transpyloric enteral feeding with 8- or 10-Fr weighted feeding tubes. Analysis was made of tolerance and complications (vomiting, abdominal distension, excessive gastric residual, diarrhea, and pulmonary aspiration) of TEF. RESULTS: The mean duration of TEF was 19.5 +/- 26.8 days (range, 1-120 days). The administration of sedative agents or inotropic drugs did not alter toleration of TEF. Eight of 12 patients treated with continuous infusion of vecuronium tolerated TEF without complications. Eleven gastrointestinal complications occurred in 10 patients, abdominal distension and excessive gastric residual in 7 (17%), and diarrhea in 4 (9.7%). In 7 patients gastrointestinal complications improved, with decreasing use or transitory interruption of TEF, but in 4 patients (9.7%), TEF had to be withdrawn. Gastrointestinal complications were more frequent in postsurgical than in nonsurgical patients (p < 0.001). No patients suffered from pulmonary aspiration, and the incidence of pulmonary infection and hepatic dysfunction diminished during TEF. CONCLUSIONS: Transpyloric enteral feeding is a good method of nutritional support in critically ill children and can be used in patients treated with neuromuscular blocking agents. The frequency and severity of complications and the risks of pulmonary infection and hepatic dysfunction related to TEF are low.

Child↗
PubMed1998

In vitro selection and characterization of human immunodeficiency virus type 1 variants with increased resistance to ABT-378, a novel protease inhibitor.

ABT-378, a new human immunodeficiency virus type 1 (HIV-1) protease inhibitor which is significantly more active than ritonavir in cell culture, is currently under investigation for the treatment of AIDS. Development of viral resistance to ABT-378 in vitro was studied by serial passage of HIV-1 (pNL4-3) in MT-4 cells. Selection of viral variants with increasing concentrations of ABT-378 revealed a sequential appearance of mutations in the protease gene: I84V-L10F-M46I-T91S-V32I-I47V. Further selection at a 3.0 microM inhibitor concentration resulted in an additional change at residue 47 (V47A), as well as reversion at residue 32 back to the wild-type sequence. The 50% effective concentration of ABT-378 against passaged virus containing these additional changes was 338-fold higher than that against wild-type virus. In addition to changes in the protease gene, sequence analysis of passaged virus revealed mutations in the p1/p6 (P1' residue Leu to Phe) and p7/p1 (P2 residue Ala to Val) gag proteolytic processing sites. The p1/p6 mutation appeared in several clones derived from early passages and was present in all clones obtained from passage P11 (0.42 microM ABT-378) onward. The p7/p1 mutation appeared very late during the selection process and was strongly associated with the emergence of the additional change at residue 47 (V47A) and the reversion at residue 32 back to the wild-type sequence. Furthermore, this p7/p1 mutation was present in all clones obtained from passage P17 (3.0 microM ABT-378) onward and always occurred in conjunction with the p1/p6 mutation. Full-length molecular clones containing protease mutations observed very late during the selection process were constructed and found to be viable only in the presence of both the p7/p1 and p1/p6 cleavage-site mutations. This suggests that mutation of these gag proteolytic cleavage sites is required for the growth of highly resistant HIV-1 selected by ABT-378 and supports recent work demonstrating that mutations in the p7/p1/p6 region play an important role in conferring resistance to protease inhibitors (L. Doyon et al., J. Virol. 70:3763-3769, 1996; Y. M. Zhang et al., J. Virol. 71:6662-6670, 1997).

Amino Acid Sequence↗
PubMed1998

Impact of invasive and noninvasive quantitative culture sampling on outcome of ventilator-associated pneumonia: a pilot study.

We performed an open, prospective, randomized clinical trial in 51 patients receiving mechanical ventilation for more than 72 h, in order to evaluate the impact of using either invasive (protected specimen brush [PSB] and bronchoalveolar lavage [BAL] via fiberoptic bronchoscopy) or noninvasive (quantitative endotracheal aspirates [QEA]) diagnostic methods on the morbidity and mortality of ventilator-associated pneumonia (VAP). Patients were randomly assigned to two groups: Group A patients (n = 24) underwent QEA, PSB, and BAL; Group B patients (n = 27) underwent only QEA cultures. Empiric antibiotic treatment was given according to the attending physician and was modified according to the results of cultures and sensitivity in Group A using PSB and BAL results and in Group B based upon QEA cultures. Bacteriologic cultures were done quantitatively for EA, PSB, and BAL. Thresholds of > or = 10(5), > or = 10(3), and > or = 10(4) CFU/ml were used for QEA, PSB, and BAL, respectively. Microbial cultures from Group A patients were positive in 16 (67%) BAL samples, 14 (58%) PSB samples, and 16 (67%) QEA samples. In Group B patients, QEA microbial cultures yielded positive results in 20 of 27 (74%) samples. In Group A, there was total agreement between culture results of the three techniques on 17 (71%) occasions. In five (21%) cases, QEA coincided with either BAL or PBS. In only two (8%) cases, QEA cultures did not coincide with either PSB or BAL. No cases of positive BAL or PSB cultures had negative QEA cultures. Initial antibiotic treatment was modified in 10 (42%) patients from Group A and in four (16%) patients from Group B (p < 0.05). The observed crude mortality rate was 11 of 24 (46%) in Group A, and 7 of 27 (26%) in Group B, whereas the adjusted mortality rates (observed crude minus predicted at admission) for Groups A and B were 29 and 10%, respectively. There were no statistically significant differences when comparing crude and adjusted mortality rates of Groups A and B. There were no differences in mortality between both groups when comparing pneumonia, considering together Pseudomonas aeruginosa and Acinetobacter spp. (Group A, 33% versus Group B, 27%). There were no differences between Groups A and B with regard to ICU stay duration and total duration of mechanical ventilation. In this pilot study, the impact of bronchoscopy was to lead to more frequent antibiotic changes with no change in mortality. Further studies with larger population samples are warranted to confirm these findings.

Adult↗
PubMed1998

Simultaneous bleaching of vital teeth and an open-chamber nonvital tooth with 10% carbamide peroxide.

OBJECTIVE: The purpose of this study was to evaluate the effectiveness of bleaching a nonvital tooth with an open pulp chamber while simultaneously bleaching the other vital teeth with 10% carbamide peroxide. METHOD AND MATERIALS: Ten discolored nonvital teeth were treated. Each nonvital tooth was prepared as in the conventional "walking bleaching" fashion, so that the gutta-percha was sealed from the pulp chamber. The 10% carbamide peroxide was injected into the chamber of the nonvital tooth and loaded into the custom-fitted tray for all teeth. The nonvital teeth were bleached from both the inside and the outside. The patient closed the orifice with a cotton pellet during the day and changed the cotton pellet after meals. The patient applied fresh solution nightly. RESULTS: All teeth were successfully lightened. The time required to lighten the nonvital tooth was related to the duration of the discoloration. CONCLUSION: With proper patient selection and education, this technique can provide an effective way to lighten nonvital and vital teeth simultaneously, especially where extended treatment time may be required for difficult discolorations.

Adult↗
PubMed1997

Bronchoesophageal fistula secondary to aspiration of tongue adhesion button in a child with glossoptosis.

A newborn boy with obstructive apnea secondary to glossoptosis was treated by securing his tongue to his lower lip. Soon after, the button that served for posterior fixation became detached and was thought to have been evacuated via the digestive tract. Twenty-two months later the infant presented with pneumonia involving the right lower lobe and hemoptysis, causing an acute respiratory distress syndrome (ARDS). After mechanical ventilation was started marked gastric distention was observed. Esophagography and bronchography revealed a fistula between the right main stem bronchus and the esophagus. During surgical repair the plastic fixation button was found in the bronchial orifice of the fistula. Despite surgical correction of the fistula the child died of refractory respiratory failure.

Bronchi↗
PubMed1997

Müllerian-inhibiting substance in follicular fluid and serum: a comparison of patients with tubal factor infertility, polycystic ovary syndrome, and endometriosis.

OBJECTIVE: To determine Müllerian inhibiting substance (MIS) levels in follicular fluid (FF) and sera of IVF patients. DESIGN: Prospective study. SETTING: Fertility center. PATIENT(S): Sixty-six patients: 20 with tubal factor infertility, 17 with polycystic ovary syndrome (PCOS), and 29 with endometriosis. INTERVENTION(S): All patients underwent ovarian stimulation with hMG and/or FSH, as well as oocyte retrieval for IVF. MAIN OUTCOME MEASURE(S): Follicular fluid and serum MIS levels and oocyte fertilization rates. RESULT(S): Levels of MIS in FF and sera of PCOS patients were significantly higher than those in tubal factor patients: 7.01 +/- 1.52 versus 1.65 +/- 0.23 ng/mL (mean +/- SE) and 2.97 +/- 0.52 versus 0.92 +/- 0.19 ng/mL, respectively. In endometriosis patients, follicular fluid and serum MIS levels were not significantly different from those in tubal factor patients. In PCOS patients, the percentage of immature oocytes retrieved (17.9% +/- 5.0%) was significantly higher compared with tubal factor (1.5% +/- 1.0%) and endometriosis (9.2% +/- 2.3%) patients. The percentage of oocytes fertilize was significantly lower in PCOS patients (30.2% +/- 5.3%) compared with tubal factor (62.2% +/- 5.5%) and endometriosis (37.5% +/- 5.7%) patients. CONCLUSION(S): Women with PCOS had higher serum and follicular fluid MIS levels, a higher percentage of immature oocytes, and lower fertilization rates than women with endometriosis or pelvic adhesions.

Adult↗
PubMed1997

Evaluation of differential effects of carbohydrate and fat intake on weight gain, serum IGF-1 and erythrocyte Na+K+ATPase activity in suboptimal nutrition in rats.

OBJECTIVE: Suboptimal nutrition leads to growth delay, frequently without over clinical or biochemical signs. We hypothesize that changes in serum IFG-1 and erythrocyte sodium-potassium ATPase activity (ENKA) may be indices of suboptimal nutrition. METHODS: Male Sprague-Dawley rats were pair-fed for 4 weeks with balanced diets of different carbohydrate (CHO) to fat (FAT) ratios (3:1, 2:1, and 1:1) and three levels of energy intake (ad-libitum, 80%, and 60%), corrected for actual body weight). Daily weight gain and weekly tail growth were monitored while ENKA, serum total protein, T3, insulin and IGF-1 were measured after four weeks. Refeeding experiments were also performed with the 3:1 and 1:1 CHO:FAT diets, including 4 weeks of dietary restriction and one week of ad-libitum feeding. RESULTS: Weight gain, tail growth, and IGF-1 decreased (p < 0.05) in all groups after 1 week of dietary restriction. A decrease in ENKA (p < 0.05) was found in rats that consumed 60% of ad-libitum energy intake only after 4 weeks. At the end of dietary treatment, weight gain was higher (p < 0.05) in rats fed the 3:1 CHO:FAT diet. In contrast, when energy was restricted to 80% or 60% of ad-libitum intake, rats fed the 1:1 CHO:FAT diet gained more weight (p < 0.05) compared to the 3:1 and 2:1 CHO:FAT diets. After 1 week of refeeding body weight, tail growth and ENKA returned to control values while serum IGF-1 levels remained depressed. CONCLUSIONS: Acute nutritional changes are clearly detected by a reduction of serum IGF-1 while ENKA may be a useful index for assessing chronic suboptimal nutrition.

Animal Nutritional Physiological Phenomena↗
PubMed1997

Life-threatening effects of discontinuing inhaled nitric oxide in children.

We treated 40 children, aged between 15 d and 17 y, diagnosed with acute respiratory distress syndrome and/or pulmonary hypertension, with inhaled nitric oxide. The most frequent underlying diagnosis associated with ARDS were bronchopneumonia (eight), cardiac surgery (five), and sepsis (three). Pulmonary hypertension was secondary to cardiomyopathy in 2 patients and occurred in the postoperative period of cardiac surgery in 17 patients--the most frequent were ventricular septal defect (5), transposition of great arteries (4), and atrioventricular septal defect (3). In 11 patients, sudden discontinuation of nitric oxide induced a decrease in oxygenation associated in some of the patients with an increase in pulmonary artery pressure. In two patients discontinuation of nitric oxide induced severe pulmonary hypertension, extreme bradycardia and hypoxaemia, which required cardiopulmonary resuscitation. When exogenous nitric oxide is abruptly interrupted, hypoxaemia and pulmonary hypertension are found in some patients, due to a decrease in the nitric oxide concentration in the pulmonary circulation. This may be caused by the exogenous nitric oxide administration that may have inhibited endogenous production. We recommend making a progressive withdrawal of inhaled nitric oxide to avoid the side effects observed in the sudden discontinuation.

Administration, Inhalation↗
PubMed1996

Application of diluted chlorine dioxide to radish and lettuce nurseries insignificantly reduced plant development.

The possible toxicity of a commercial chlorine dioxide preparation (Halox E-100) was evaluated on radish and lettuce seedlings growing in pots under controlled conditions. A single application of various dilutions to radish seedlings growing in a sterile or nonsterile commercial plant substrate only slightly decreased plant dry weight. At the end of the experiments, the plants appeared unaffected by the treatments. Other common plant parameters (root and stem length, number of true leaves) were unaffected or even enhanced. Halox did not reduce the total level of soil bacteria even after four consecutive applications at any dilution rate. In nonsterile soil, high Halox dilution (1:1000) significantly decreased plant dry weight, and the other concentrations (1:10,000; 1:50,000, and 1:100,000) had no apparent effect on the size of the plants. In sterile soil, high concentrations of Halox (1:1000 and 1:10,000) significantly decreased plant growth, but higher dilutions produced no significant reduction in plant dry weight. For radish plants growing in organic matter-free sand only, dilution of 1:10,000 reduced plant growth. On lettuce plants, dilutions from 1:5000 to 1:25,000 did not reduce plant growth. High levels of Halox (1:1000) were toxic to both radish and lettuce seedlings growing in sand and resulted in chlorosis and significant depression of plant growth. Further dilutions of Halox (equivalent to the level used in water disinfection) significantly decreased toxicity for both plant species. Low concentrations of Halox (> 1:50,000) had no apparent effect on the appearance of both plant species. In conclusion, this study suggests that chlorine dioxide-treated drinking water can be considered safe for growing plants; this treatment should be further evaluated using other plant species under more realistic growth conditions.

Chlorine↗