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Biomedical subjects

A García García

Publications and source records attributed to A García García.

At least 19 recordsLinked to original sources
PubMed2001

[Bilateral diaphragm paralysis after cardiac surgery].

We report two cardiac surgery patients on whom local hypothermia with slushed ice for myocardial protection was used. Bilateral diaphragm paralysis with respiratory failure occurred. In both cases, neurophysiologic studies have been used for the diagnosis. Prolonged ventilatory support was required for several weeks and they were totally recovered after months.

Aged↗
PubMed1998

[Identification of the ischemic origin of dilated myocardiopathy using positron emission tomography].

INTRODUCTION AND OBJECTIVES: The aim of this study was to differentiate ischemic from nonischemic dilated cardiomyopathy with positron emission tomography. This differentiation is necessary to establish an adequate treatment, and it is often difficult with non-invasive diagnostic procedures. METHODS: Ten patients with an echocardiographic diagnosis of dilated cardiomyopathy who had undergone coronary angiography were selected. The presence or absence of angiographic coronary lesions was used to define the ischemic (n = 6) and the nonischemic group (n = 4). The ejection fraction was depressed in both groups, with no significant differences found. A perfusion study with 13N-ammonium and a metabolic imaging with 18F-florodeoxyglucose were performed on each patient. The images were quantitatively and qualitatively analysed, defining three criteria: accumulation defect (areas with activity under 50% of the maximal radioactivity), degree of heterogeneity, and match of images with both tracers. To determinate the degree of heterogeneity, nine segments on the three standard tomographic planes were studied. Based on the following heterogeneity features: irregular borders, coexisting different degrees of accumulation, and patched accumulation, a score ranging from 0 to 3 points was assigned to these segments. To analyse the radioactivity defects and the matching of studies with both tracers, the accumulation defects or the accumulating surface were outlined on a midventricular level coronal plane. RESULTS: The ischemic group has contrary to the nonischemic one, wider perfusion (0.26 +/- 0.21 vs 0.00) and metabolism defects (0.38 +/- 0.30 vs 0.06 +/- 0.09; p < 0.05). The degree of heterogeneity is significantly higher in the nonischemic group, either in perfusion (14.5 +/- 8.38 vs 2.5 +/- 1.04; p < 0.05) or in metabolism studies (15.5 +/- 3.31 vs 2.33 +/- 1.50; p < 0.005). Assigning wide defects and homogeneous accumulation to ischemic cardiomyopathy, and absence of defects and heterogeneous accumulation to nonischemic cardiomyopathy, the aetiology of the disease was identified in 9 of the 10 cases in the perfusion study and 100% of them with the metabolism imaging. CONCLUSIONS: Positron emission tomography allows to identify the aetiology of dilated cardiomyopathy, either with coronary perfusion or with myocardial glucose metabolism studies. Thus, only one of both PET studies could be used. Ischemic cardiomyopathy is characterised by wide defects and homogeneous radioactivity, and the nonischemic one by the absence of defects and heterogeneous accumulation of the tracer.

Aged↗
PubMed1998

[Cyclosporine in inflammatory bowel disease].

Inflammatory Bowel Disease (IBD), as Ulcerative Colitis (UC) as well as Crohn's Disease (CD), can appear as severe outbreak resistant to steroid treatment. These cases require surgery or immunosupressive therapy (mercaptopurine or azathioprine). Cyclosporine A (CYA) is a selective, reversible immunosupressor of the T helper lymphocites, used in the treatment of organ transplants and in certain autoimmune diseases. CYA is not a first line therapy for IBD. In spite of the positive results obtained in some uncontrolled studies, only one randomized trial has shown the superiority of CYA over the placebo in the treatment of UC and avoided colectomy in one third of the patients with the severe form of this disease. It can also contribute to the healing of resistault CD fistulaes. The potential toxicity of CYA and the few controlled clinical trials limit its use. However CYA needs to define its role in the treatment of IBD through II more controlled trials.

Cyclosporine↗
PubMed1998

[An epidemiological study of the thrombocytopenia with radial aplasia syndrome (TAR) in Spain].

OBJECTIVE: There are numerous published papers on TAR syndrome. Nevertheless, most of them refer to cases or families with several affected members, but we could find no publication epidemiologically analyzing a consecutive series of cases. PATIENTS AND METHODS: We show the characteristics of the six cases with TAR syndrome identified in the consecutive series of 25,967 malformed live born infants detected among 1,431,368 live births surveyed by the ECEMC (Spanish Collaborative Study of Congenital Malformations) since April 1976 until June 1997. RESULTS: The minimal estimated frequency of TAR syndrome in our area is 0.42 per 100,000 live born infants, with a confidence interval of 0.15 to 0.91. There was no known consanguinity among the cases' parents, nor other affected family members. The sex ratio was 1:1. Although it is generally considered that the syndrome is autosomal recessive, genetic heterogeneity cannot be ruled out. CONCLUSIONS: Our cases concur with published data with respect to the low frequency of consanguineous parents. However we did not find a higher proportion of girls affected as has been described previously.

Abnormalities, Multiple↗
PubMed1997

Esophageal candidiasis in HIV-negative patients.

UNLABELLED: Candida esophagitis is the most frequent esophageal infection in HIV seropositive as well as in seronegative patients. AIM: this retrospective study was designed to determine the characteristics of this disease in HIV negative patients in a general hospital. DESIGN: clinical records of all HIV negative patients with Candida esophagitis, which was endoscopically diagnosed and microscopically confirmed (biopsy and/or cytology of esophageal mucosa), were studied. RESULTS: thirty-one patients (23 men, 8 women, mean age: 65.4 +/- 14.3 years, median 71) fulfilled the criteria (0.56% of the diagnostic esophagogastroduodenal endoscopies). The most common clinical symptoms were dysphagia with or without odynophagia and pain (retrosternal, epigastric or xiphoid). Fourteen patients (45%) had no esophageal signs; in nine of them (29%) the disease was diagnosed in the course of an endoscopic exam to investigate the sources of acute or chronic anaemia. The most frequent predisposing factors were diabetes mellitus, oral or aerosolized corticotherapy, malignancies, treatment with broad-spectrum antibiotics and liver cirrhosis. Nine patients (29%) presented no known predisposing factors. The most common endoscopic appearance was grade II (51%). Sixty-one per cent of the patients exhibited at least one other esophagogastroduodenal endoscopic lesion associated with the mycosis. Three patients died of their underlying diseases within one week of the diagnosis of the candidiasis. Only one patient presented persistence of candidiasis one week after initiating treatment with oral nystatine. CONCLUSIONS: esophageal candidiasis is infrequent and does not always present with suspicious symptoms or known predisposing factors. Aerosolized corticotherapy may be a risk factor for the development of esophageal candidiasis.

Adult↗
PubMed1993

[The use of vagina and percutaneous surgery in stress urinary incontinence: description, foundations, and indications].

Our modifications to the Stamey, Guittes and Raz procedures are described and discussed. Our own experience of seven years and the experience reported by other authors in the world literature demonstrate the usefulness of the vagina in endoscopic percutaneous surgical treatment of female stress urinary incontinence. The complication rate is reduced, efficacy is enhanced and different alternatives are possible depending on the anatomic and functional characteristics of each case.

Female↗
PubMed1993

[The defecation habits in a normal working population].

We have studied the bowel habits of a theoretically normal working population to know the range defecation patterns, characteristics and main factors that may influence it. We have designed a questionnaire composed of 80 questions and distributed to 837 people. Answers, were evaluated in 414 cases (187 men and 227 women), with a median age of 33 years (range 20-64 years). The average number of stools was 7.1 +/- 3.3 per week and in 62.4% of subjects they were between the range of 5 and 8. Bowel movements were less frequent in women than in men, and the same finding was seen about self-reported constipation; nevertheless there were no differences in regard to age. Laxatives were used regularly by 11.3%, and 36% referred straining at stool at least 25% of the time and 8.3% referred straining for loose stools. Alternating bowel function presented in 19.4% and functional abdominal pain in 28% with a female predominance. Faecal incontinence occurred in 6.8% of population; an important prevalence. We also analyse variables such as diet influence, physical activity, obstetrical, gynaecological and psychosocial factors. Although this survey has revealed that a normal bowel function is very variable, only a 7.5% of the subjects, consulted a doctor for bowel complaints.

Adult↗
PubMed1988

Rapid effects of adult-onset hypothyroidism on dendritic spines of pyramidal cells of the rat cerebral cortex.

We have previously shown (Ruiz-Marcos et al. 1980, 1982) that thyroidectomy (T) performed in rats at 40 days of age, well past the neonatal period of development, results by 80-90 days of age in a decrease of the number of spines along the shaft of pyramidal neurons with the cell body in layer V in the visual area of the cerebral cortex. We have here studied how soon after the operation an effect on spine number and distribution may be observed. We have found that the response of these neurons to T is very rapid: a decrease in the number of spines/shaft between T and age-paired controls (C) rats is statistically significant by the earliest period of observation, namely 5 days after T. These results may be related to those of Dembri et al. (1983) showing that T performed in adult rats decreases the activity of Type I RNA polymerase by 5 days after the operation. It is possible that T impairs the synthesis of some compound(s) necessary for the formation and maintenance of spines. The present results suggest that spine number is not a fixed structure of the apical shaft once brain development is over, but is in a state of continuous formation and degradation. We have further observed that the effect of T performed at 40 days of age is more pronounced in the distal part of the shaft than on the rest, a result similar to that found after neonatal T (Ruiz-Marcos et al. 1982). However, contrary to findings after early hypothyroidism, T at 40 days of age does not distort the distribution of spines along the shaft.

Animals↗
PubMed1984

[Cutaneous manifestations of the malabsorption syndrome].

A review of the skin changes in malabsorption syndrome, is presented; dividing the symptoms in skin, mucous membranes and adnexal involvement. In this way, acquired ichtyosis, hiperpigmentation changes, purpura and echimosis and eczematoid or psoriatic-like with generalized pruritus are described. The mucous membranes alterations are the most frequent ones, the angular cheilitis, glositis, ulcerations and aphthaes are pointed out, as well as the changes in the shape and colour of hair and nail abnormalities. Special mention deserve the particular cases of malabsorption syndromes that appears in: acrodermatitis enteropathica, dermatitis herpetiformis, Whipple disease, Cronkhite-Canada syndrome, dermatogenic enteropathy and abnormalities that occur as complication from the surgery treatment for obesity improvement.

Arthritis↗
PubMedDate not supplied

[Intervention of a pharmacy department following the 11-M terrorist attack].

OBJECTIVE: To describe the intervention of a pharmacy department, as well as medication requirements, in the healthcare emergency situation brought about by the terrorist attack of March 11, 2004 in Madrid. To compare this intervention with other similar experiences reported in the medical literature. METHOD: A compilation of actions carried out by pharmacists directly involved in the management of this incident. A literature search of Medline, Cochrane Library, and Spanish Index Medicus databases. RESULTS: The pharmacy department acted to ensure the availability of all medication needed in the management of casualties by placing urgent orders in pharmaceutical laboratories, simplifying distribution networks, and staying in permanent contact with the medical and nursing staff of the emergency department, as well as with people in charge of emergency coordination. Most commonly used medications included plasma expanders, fluid therapy, blood-derived products, pain killers, antiseptics, peripheral myorelaxants, and antibiotics, which are consistent with those employed by other Madrid hospitals for this same attack. CONCLUSIONS: The pharmacy department, as any other department in a hospital, should be ready to rapidly and effectively cope with any emergency situation. Having a protocol available including major intervention guidelines is advisable to reduce reaction times, anticipate potential complications, and effectively solve such situations.

Emergency Service, Hospital↗