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Biomedical subjects

A Valverde

Publications and source records attributed to A Valverde.

At least 37 records · Page 2Linked to original sources

[Mediastinal and cervical diffusion of necrosis infiltration in acute pancreatitis].

Thoracic complications of acute pancreatitis are mainly caused by the rupture of the main pancreatic duct leading to the diffusion of pancreatic juice into the mediastinum. Occasionally, esophagus or respiratory tract may also be involved. We report here the case of a 51-year-old man with acute alcohol-related pancreatitis who developed mediastinal and cervical infiltration through a wirsungo-mediastinal fistula caused by the leak of the main pancreatic duct which was successfully treated by splenopancreatectomy.

Humans↗

Evaluation of the new API Candida system for identification of the most clinically important yeast species.

The API Candida system (bioMérieux) a new yeast identification system, was evaluated for its reliability in identifying 198 clinical yeast isolates in comparison with the API 20C system (bioMérieux) that was used as reference standard. The API Candida system correctly identified 91.4% and 71.7% of the isolates, with and without additional tests, respectively. The API Candida system identified 96.3% of common isolates studied, and 66.6% of uncommon isolates. We think that API Candida system is an easy and good yeast identification system and it could be used in a routine clinical microbiology laboratory.

Candida albicans↗

[Activity of trovafloxacin and ten other antimicrobials against gram negative anaerobic bacilli].

As an increase in anaerobes resistant to a great variety of antimicrobials have been seen in the last few years, a search for new agents with activity against these microorganisms is needed. One of these agents is trovafloxacin. In our study, all strains were susceptible to imipenem, metronidazole, chloramphenicol and piperacillin/tazobactam. A total of 97% of the strains were inhibited with 2 mg/ml of trovafloxacin. The microorganisms Bacteroides fragilis and B. uniformis showed the least susceptibility against the antimicrobials studied, with a MIC90 for trovafloxacin of 1 and 2 mg/ml, respectively. Fusobacterium spp. were the most susceptible, with an MIC90 for trovafloxacin of 0.5 mg/ml. Trovafloxacin showed good activity against Gram-negative anaerobe rods, and could therefore be considered as an alternative in the treatment of the infections produced by these microorganisms.

Anti-Infective Agents↗

Estrogenic effects of p-hydroxybenzoic acid in CD1 mice.

Xenobiotic estrogens in the environment or diet have received much attention as a possible source of certain hormonal disease states in human and wildlife. Therefore, the detection of estrogenic activity of any substance, especially those related to the food industry, is important. The estrogenic activity of p-hydroxybenzoic acid (PHBA), a compound related to a commonly used group of preservatives in food, cosmetic, and pharmaceutical preparations, was evaluated with immature and adult ovariectomized female mice (CD1) using two well-known bioassays. Subcutaneous administrations (s.c.) of different doses of PHBA were compared with estradiol (E2), and their effects on vaginal cornification and uterotrophic activities were evaluated. Different groups of animals were treated s.c. daily for 3 days with vehicle (corn oil, 0.3 ml/100 g), E2 (1 microgram/100 g), and PHBA (0.5, 5, 50, and 500 micrograms/100 g). Four days after treatment, PHBA produced a dose-dependent response on vaginal cornification and uterotrophic activity in both immature and adult ovariectomized mice. The relative uterotrophic potency of PHBA (500 micrograms/100 g) to E2 (1 microgram/100 g) was 0.0011 in immature mice and 0.0018 in ovariectomized animals.

Animals↗

Effect of age on the exocrine pancreatic secretion of the preruminant milk-fed goat.

The effect of age on the exocrine pancreatic function was studied in fifteen Granadina goat kids during the second, third and fourth postnatal week. The animals, chronically catheterized, were bottle-fed on goat milk twice a day. Pure pancreatic juice was collected from 1 hour before and throughout 8 hours after milk ingestion. Pancreatic flow rate, bicarbonate and chloride concentrations, total protein content and enzyme activities were determined. In resting conditions, pancreatic flow rate augmented with age, probably reflecting an increase in body and pancreas weight. Resting amylase and lipase activities recorded significant increases during the fourth week of life. That may be associated, respectively, to the immediate change to a high-starch diet and to a simultaneous decrease in the salivary lipase levels. Our results also showed age-related differences after ingestion of milk, mainly concerning the volume response and the lipase output. The latter can be explained in the same way as regarding resting conditions. With respect to the volume response, several factors could be implicated, such as the circulating levels of gastrointestinal hormones, the sensitivity of the pancreas to such stimuli, the maturation degree in the secretory mechanisms of the gland or the development of the digestive tract.

Aging↗

Exocrine pancreatic secretion in suckling goats. Adaptative effects of maternal milk and a milk substitute.

Suckling goats were fed ad libitum during the first month of their life by goat milk or by a milk replacer. These diets differed in the amount of fat and the type of protein. The composition of the exocrine pancreatic secretion in the basal period and in response to food were compared in both conditions. Pancreatic juice was collected one hour before meal intake up to the 8th postprandial hour. Pancreatic flow rate, bicarbonate and chloride levels, total protein and enzyme activities were measured. In resting conditions and in response to food, the lipase activity was found to be significantly lower in the group fed with milk replacer, which was poorer in fat. These results indicate an adaptation of the enzyme output to the available quantity of its substrate, similar to that described in the rat. Postprandial differences in the pancreatic flow rate, electrolytes and total protein were found between both groups. Their origin can be attributed to the protein used (soyabean) in the milk substitute. Such soya protein alters the normal clot formation in the abomasum and allows an accelerated abomasal digesta outflow and duodenal pH alkalinisation.

Adaptation, Physiological↗

Determination of a sedative dose and influence of droperidol and midazolam on cardiovascular function in pigs.

Twelve pigs were randomly assigned to 1 of 2 groups, droperidol or midazolam, to determine a sedative dose of each drug that would facilitate handling of the pigs. Each pig in the group received all of the test doses with 5-7 d between treatments (droperidol--0.1, 0.3, 0.6 mg/kg, or midazolam--0.25, 0.5, 1.0 mg/kg) and saline (3 mL), i.m. One investigator, unaware of the treatment administered, assessed the time of onset, degree, and duration of sedation. The 0.3 mg/kg dose of droperidol and 0.5 mg/kg dose of midazolam were judged to be the most suitable for sedation and produced similar degrees of sedation, although the onset and duration of sedation was significantly longer for the droperidol group. The effects of these 2 doses on heart rate, respiratory rate, systolic blood pressure, and rectal temperature were assessed in 12 pigs randomly assigned to 1 of the 2 treatments. Respiratory rate decreased significantly with droperidol at 10, 15, and 30 min. Temperature was significantly decreased at 60 min following midazolam. This study demonstrates that 0.3 mg/kg i.m. of droperidol and 0.5 mg/kg i.m. of midazolam induce adequate sedation in pigs with minimal cardiorespiratory changes.

Animals↗

[Pancreatoblastoma in adults].

Pancreatoblastoma is a rare pancreatic tumor, which usually occurs during childhood. We describe here the ninth adult case in a 21-year-old woman, who died 7 months after diagnosis despite complete surgical resection and adjuvant chemotherapy. Pancreatoblastoma in adults has a poor prognosis, at variance with what may be observed in childhood.

Adult↗

Determination of imidacloprid in vegetables by high-performance liquid chromatography with diode-array detection.

An HPLC method is described for the determination of imidacloprid residues in vegetables at levels ranging from 0.01 to 0.60 mg/kg. The selection of the extraction and clean-up procedure is discussed. Spectral data obtained with diode-array detection allow the identification of imidacloprid residues. Thermospray mass spectrometric studies were carried out in combination with HPLC. The mean recoveries and standard deviations were 95% and 4.7%, respectively, in the various crops tested. Registration of the analytical results for a control sample in quality control charts demonstrated the performance of the method. Data for incurred residues of imidacloprid in vegetable samples routinely applying the proposed method are also presented.

Chromatography, High Pressure Liquid↗

Post-natal changes in biliary lipids in suckling goat kids.

The post-natal composition of biliary lipids in the bile of suckling goat kids has been studied during the first month of life. Samples of hepatic and vesicular bile were obtained from animals fed with milk. Bile flow increased with age and the concentration of bile acids also rose up to 14 days of age. Cholesterol reached maximum values immediately after birth and then decreased. Bile acids conjugated with taurine predominated and this pattern of preferential tauroconjugation persisted at all ages, as has also been found in carnivores and sheep. Comparison of vesicular and hepatic bile composition revealed a poor concentration capacity of the gallbladder in pre-ruminant kids.

Aging↗

Manual versus mechanical esophagogastric anastomosis after resection for carcinoma: a controlled trial. French Associations for Surgical Research.

BACKGROUND: Mechanical anastomosis has been claimed to reduce the rate of leakage compared with manual anastomosis. No randomized trials have been performed to date to prove this specifically in esophagogastric anastomosis. METHODS: One hundred fifty-four patients, 139 men and 15 women ranging in age from 36 to 83 years (mean, 50 +/- 10 years) and undergoing elective resection of esophageal or cardial carcinoma, were included in this multiinstitutional (14 centers) randomized study comparing the rate of anastomotic leakage after esophagogastric anastomosis performed manually or mechanically. Eligible for this study were patients with esophageal or cardial carcinoma located between the esophagogastric junction (included) and the upper border of the aortic arch. The choice between resection with or without thoracotomy was left to the discretion of the operating surgeon. Proximal resection of the fundus was mandatory. Intestinal tract continuity was reestablished in a one-stage procedure by an esophagogastric anastomosis without interposition of either the jejunum or the colon. The site of the anastomosis could be either intrathoracic or cervical. The principal end point was anastomotic leakage as judged by (1) egress of intestinal fluids or orally ingested methylene blue through drains, (2) sodium diatrozate swallow prescribed either routinely for all patients between postoperative days 3 and 8 or because of signs of leakage, or (3) reoperation or autopsy. RESULTS: After two patients were withdrawn for protocol violation, 152 patients, 74 in the manual group and 78 in the mechanical group, were studied. The number of anastomotic leakages was identical in both groups (n = 12, 16% and 15%, respectively). Overall 30-day mortality was 11%. Fewer deaths occurred in the manual group (7%), which had three anastomotic leakages, than in the mechanical group (15%), which had five anastomotic leakages, and fewer repeat operations were done in the manual group (n = 9) than in the mechanical group (n = 13), but both of these differences were not statistically significant. The duration of anastomosis and of operation was similar in both groups. In the mechanical group 16 anastomoses (20%) gave rise to technical mishaps (either in the fashioning of the purse-string, dilation of the esophagus, or in stapling). Among the factors recognized as potentially preventing leakage, only testing for airtightness was significantly correlated with less postoperative leakage (p < 0.05). Eight postoperative strictures were recorded at 3 months in 62 (13%) patients in the manual group, whereas seven strictures occurred in 53 (13%) patients in the mechanical group. CONCLUSIONS: When mechanical staples rather than manual sutures are chosen, the disadvantages (technical mishaps and higher costs) are not counterbalanced by a gain of time or a decrease in the rate or severity of anastomotic leakage.

Adult↗

Biliary secretion in suckling goats: the effect of maternal milk and of a lamb milk replacer.

A total of 45 preruminant goats were fed either goat milk or a milk substitute. The postnatal development of bile secretion and biliary lipids composition of suckling goats and the influence upon these parameters of maternal milk substitution were studied during the first month of life. Samples of hepatic and gallbladder bile were obtained from kids of 1, 7, 14, 21 and 28 day-old. Bile flow rate, cholesterol, total bile salts and phospholipids were measured. Our results show that the quality of the protein and fat used in the elaboration of the milk replacer, affects the evolution of both hepatic bile flow and biliary lipids composition. Differences between gallbladder and hepatic bile composition show a scarce concentration capacity of the gallbladder with both diets and at all ages studied.

Animals↗

Conjugated bile acids and intestinal flora during the preruminant stage in goat. Influence of a lamb milk replacer.

A total of 45 preruminant goats were fed either goat milk or a milk substitute to compare the evolution of taurine and glycine conjugated bile acids and the evolution of the intestinal flora during the first month of life. Samples of hepatic bile were obtained from kids of 1, 7, 14, 21, and 28 days old and conjugated bile acids were measured by high performance liquid chromatography. Bacterial flora were determined in 14 and 28 day old animals. Ours results show that under our experimental conditions tauroconjugated bile acids clearly predominated over the conjugated with glycine. This pattern of preferential tauroconjugation persisted at all ages tested and in both groups studied. On the other hand, it seems that the quality of the protein and fat used in the elaboration of the milk replacer affects the intestinal flora and the postnatal evolution of conjugated bile acids.

Animals↗

[Imaging of peripheral cholangiocarcinoma. Comparison with pathological anatomy].

OBJECTIVE: Peripheral cholangiocarcinoma is a rare malignant intrahepatic tumor which originates in the distal bile duct. Our purpose was to identify the imaging characteristics of peripheral cholangiocarcinoma and to establish a correlation with surgical and histopathologic findings. METHODS AND MATERIALS: The imaging data of 16 patients with proven cholangiocarcinoma were retrospectively reviewed by sonography in 13 cases, computed tomography in 13 cases, magnetic resonance imaging in 6 cases, and angiography in 10 cases and correlated with surgical and histopathologic findings. RESULTS: In most cases peripheral cholangiocarcinoma appeared as a single, large (> 10 cm), heterogeneous, and non encapsulated mass. On precontrast computed tomography, the lesions were mostly low density. Enhancement was moderate in the bolus phase and increased in the delayed scan. With magnetic resonance imaging, lesion signals were low intensity in T1-weighted images and variable intensity in T2-weighted images. On angiogram, lesions were often hypovascular. Associated features were frequently observed: portal encasement (69%), lobar atrophy or capsular retraction (43%), dilated intrahepatic bile ducts (30%), extension into the hepatic capsule (23%), and inferior vena cava extension (15%). Radiopathologic comparison showed that imaging modalities accurately identified vascular encasement, but underestimated extrahepatic tumor extension. CONCLUSION: In most cases, peripheral cholangiocarcinoma has a typical appearance which may be helpful in differentiating this disease from other intrahepatic tumors.

Adult↗

[Toxic megacolon with colonic perforation complicating Campylobacter jejuni ileo-colitis].

Campylobacter jejuni is an enteropathogen with invasive ability which may be responsible for acute colitis. We report the case of a 38-year-old woman who was hospitalized for severe acute colitis. Stool specimen examination revealed Campylobacter jejuni. A laparotomy was performed due to clinical deterioration and toxic megacolon. Colic perforations were observed. The examination of the colectomy specimen revealed ulcerative pancolitis. This is the first published case of Campylobacter jejuni infection complicated by toxic megacolon and perforation.

Adult↗

[Ascites after liver transplantation in children].

The objective of this study, based on a series of 148 transplants performed in 131 children, was to evaluate the frequency, complications and predisposing factors of ascites occurring after liver transplantation (LT). The diagnosis of post-LT ascites was defined as a drainage rate greater than 25 ml/kg/day (or- > 500 ml/day) persisting for at least 72 hours after removal of the drains. Among the 123 transplants analysed, 31 (25.2%) were complicated by ascites (group I). Group II consisted of 92 LT without ascites. This ascites was predominantly lymphocytic (669 +/- 1,104/mm3), rich in proteins (32 +/- 13 g/l), with a low triglyceride concentration. The mean duration of ascites was 25 +/- 19 days. Complications of ascites included: infection of ascitic liquid (35%), respiratory complications (65%), parietal complications (50%), consumption coagulopathy (35%), functional renal failure (Creat > 130 mumol/l, 35%). There were 9 deaths (29%) in group I versus 8 in group II (p < 0.02). The predictive factors, pre-LT, of postoperative ascites included: serum bilirubin > 300 mumol/l (p < 0.02); PT < 30% (p < 0.05); and serum albumin < 30 g/l (p < 0.05). Intraoperative factors favouring the development of ascites were end-to-side cavo-caval implantation of the graft when it was reduced (p < 0.02) and a volume of transfused blood after unclamping greater than 60 ml/kg (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Human immunodeficiency virus and infected aneurysm of the abdominal aorta: report of three cases.

Three patients who were seropositive for human immunodeficiency virus underwent surgery for infected aneurysm of the abdominal aorta. Fever and abdominal pain were the principal presenting clinical features. None of the patients had any opportunistic infections or endocarditis. In two cases, a ruptured aneurysm was demonstrated radiographically. In the remaining case, sonograms were diagnostic. The organisms responsible were salmonella, Hemophilus influenzae, and Mycobacterium tuberculosis. In two cases, the infectious origin was evidenced by bacteriologic examination of the aortic wall, which revealed the presence of Salmonella enteritidis and Koch's bacillus. Although Hemophilus influenzae was not found in the aortic wall of the remaining case, the infectious origin of the aneurysm was established because preoperative blood cultures were positive for this pathogen, and pathohistologic examination of the specimen showed destruction associated with leukocyte infiltration of the aneurysmal wall. An in situ prosthetic graft replacement protected by omentum was performed in all three cases. Antibiotic therapy was continued for several weeks. All patients are well with follow-up ranging from 10 to 21 months. Infectious aneurysm associated with human immunodeficiency virus seropositivity results in bacterial infestation of an atheromatous aorta. Infected phenomena are promoted by cellular immunodeficiency. Surgery was justified in these cases because of the immediate threat of rupture.

Acquired Immunodeficiency Syndrome↗