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Biomedical subjects

C Barrios

Publications and source records attributed to C Barrios.

At least 73 records · Page 4Linked to original sources
PubMed1990

Ascitic fluid polymorphonuclear cell count and serum to ascites albumin gradient in the diagnosis of bacterial peritonitis.

The analysis of ascitic fluid has been complicated by several recently reported new tests. To simplify this assessment, we evaluated nine parameters prospectively and simultaneously in blood and ascitic fluid from 285 patients with ascites to determine which were the most reliable for immediate diagnosis of the etiology of the ascites and of its complications. Subjects were first divided into four groups: sterile cirrhotic ascites (n = 201), spontaneous bacterial peritonitis (n = 41), malignant ascites (n = 34), and miscellaneous ascites (n = 9). An ascitic fluid polymorphonuclear count greater than 500/microliters was the test with the greatest accuracy (96%) for the diagnosis of spontaneous bacterial peritonitis. Neither the most precise cutoff values for ascitic fluid pH (less than 7.32) and ascitic fluid lactate (greater than 32 mg/dl), nor their respective blood-ascitic fluid gradients (greater than 0.11 and less than -20 mg/dl) were more reliable indexes of spontaneous bacterial peritonitis, mainly due to the decreased ascitic fluid pH and increased ascitic fluid lactate observed in malignant ascites, tuberculous peritonitis, and pancreatic ascites. A blood-ascitic fluid albumin gradient less than 1.1 g/dl was the most accurate parameter for the diagnosis of malignant ascites (diagnostic efficacy, 93%). Therefore, the etiologic analysis of ascitic fluid might be simplified and the single practice of two tests, ascitic fluid polymorphonuclear cell count and blood-ascitic fluid albumin gradient, provides immediately useful information.

Adult↗
PubMed1990

Postoperative improvement of walking capacity in patients with trochanteric hip fracture: a prospective analysis 3 and 6 months after surgery.

Between 1982-1985, 149 patients with trochanteric fractures were randomly selected for treatment with either Ender nails or a sliding nail plate. Ninety-two patients were able to perform walkway tests on an electronic walkway and were considered the best prospects for rehabilitation. Thirty-seven patients' fractures were stabilized with Ender nails and 55 with a sliding nail plate. Gait analyses were made at 3 and 6 months after surgery. Change in walking capacity based on four parameters (walking aids, walking distance, maximal vertical force, and single limb support) was compared to changes in clinical and radiographic parameters at 3 and 6 months after surgery. In all, less than half of the patients had achieved their preoperative status 3 months after surgery. Between 3 and 6 months postoperatively, 42 patients experienced less pain, 23 improved in range of hip motion, and 12 improved in strength. According to multivariate regression analysis, the significant factors associated with improvement in walking capacity during this period were an unstable fracture type (p = 0.003), improvement of hip strength (p = 0.006), and improvement of pain (p = 0.03). In conclusion, rehabilitation of patients with trochanteric fractures, particularly in those patients with unstable fractures, should be continued for more than 3 months after surgery.

Adult↗
PubMed1990

Secondary repair of ulnar nerve injury. 44 cases followed for 2 years.

A series of 44 patients with complete section of the ulnar nerve was reviewed on average 2 years after secondary repair. The procedures applied were fascicular grafting in 33 cases, epineural suture in 7, and suture in 4. Useful ulnar motor function was restored in 22 cases of fascicular grafting, in all 4 of fascicular suture and in 3 of epineural suture. Sensibility recovered in 23 patients operated on by fascicular grafts and in 10 of 11 treated by epineural or fascicular suture. Cases with unsatisfactory results had other associated severe lesions, i.e., median nerve section, vascular damage or tendon injuries. Early repair of clean-cut nerve sections by fascicular or epineural suture gives a good chance for recovery. Grafting should be performed within 3 months and no later than 1 year after the injury.

Adolescent↗
PubMed1990

Microsurgery versus standard removal of the herniated lumbar disc. A 3-year comparison in 150 cases.

The outcome of 150 patients with herniated lumbar disc treated by either microsurgical or standard discectomy were retrospectively reviewed after an average of 3 years. Both techniques provided satisfactory results, with 85 percent good or excellent outcome. Microsurgery gave less intraoperative bleeding, shorter hospitalization, and more rapid return to work. The main drawback was a higher recurrence rate of disc prolapse.

Adolescent↗
PubMed1990

Clinical factors predicting outcome after surgery for herniated lumbar disc: an epidemiological multivariate analysis.

A 5-year retrospective study of 150 patients operated on for lumbar disc herniation was conducted to evaluate the prognostic significance of several clinical variables in outcome. Patients with a clear lumbar herniated disc as diagnosed by computed tomography and/or myelography were operated on after a failed conservative treatment. Excellent outcome was defined as complete relief of complaints and neurological deficits. Mean follow-up period comprises 4 years; range, 2-6. At review, an excellent outcome was obtained in 73 patients (49%). Analyzing each variable separately, the application of autotraction during conservative treatment showed the major prognostic value, predicting excellent outcome. Other statistically significant parameters were a sedentary type of work and absence of motor or sensory deficits. The presence of intraoperative complications, namely dural tears, level errors, or root damage, indicated a poor prognosis. When the combined influence of all epidemiological variables was assessed by multiple regression analysis, a significant correlation could be found; the use of autotraction prior to surgery was the most important predicting factor. This study shows that there are some clinical factors that could fairly predict the surgical outcome of patients with lumbar disc herniation.

Adult↗
PubMed1989

Abolition of mevinolin-induced growth inhibition in human fibroblasts following transformation by simian virus 40.

The basal level of the gene expression and the activity of 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase was higher in SV40-transformed human fibroblasts (90-VA VI) than in normal ones (HDF). In both these cell types mevinolin (25 microM) caused an 85-90% depression of HMG CoA reductase activity and of the incorporation of [3H]acetate into sterols. In HDF this was coupled to an efficient block of cell growth, whereas the growth of 90-VA VI was only slightly reduced by mevinolin. In HDF, mevinolin (25 microM) also abolished essentially all dilichol synthesis, as measured by incorporation of [3H]acetate. In contrast, dolichol synthesis remained unaltered, or was increased, in mevinolin-treated 90-VA VI. We suggest that these different responses of dolichol synthesis may depend on different substrate affinities of the rate-limiting enzyme in the dolichol pathway. However, if 90-VA VI was treated with 25-hydroxycholesterol (25-OH), an alternative inhibitor of HMG CoA reductase, the cellular growth as well as dolichol synthesis was significantly decreased. Since the inhibitory effect of 25OH on HMG CoA reductase activity did not exceed that of mevinolin, it seems that 25-OH, besides HMG CoA reductase, inhibits steps distal to HMG CoA reductase. This notion was further supported by the finding that addition of mevalonate did not prevent the 25-OH-induced growth inhibition. However, if dolichol was added along with 25-OH, the block was partially prevented, indicating that a critical level of de novo synthesis of dolichol for cellular growth.

Cell Division↗
PubMed1989

Paraspinal muscle pathology in experimental scoliosis.

Paraspinal muscle biopsies from ten rabbits with experimentally induced scoliosis and from four healthy controls were analyzed histologically and histochemically. Scoliosis was induced by two different methods: six animals underwent unilateral damage of the dorsal column of the spinal cord (mean curve: 22 degrees) and four costotransversectomy (mean curve: 47 degrees). In eight scoliotic animals myopathic changes were detected on the muscles of the concave side. Only those animals which underwent costotransversectomy showed a neuropathic pattern with cronic denervation changes on the convex side. As regards the fiber type distribution, the control group showed a higher percentage of type-I fibers, which were similar on both sides of the spinal cord. No fiber proportion asymmetry could be detected in the muscles on the concave side in normal or scoliotic rabbits. There was a tendency to depart from normal values, in two different ways, on the convex side of scoliotic animals. Thus, in contrast to the medullary damage group, the muscles of the costotransversectomized rabbits showed an increased proportion of type-I fibers. Taken together, our findings support the hypothesis that myopathic changes as observed in human idiopathic scoliosis are a consequence of the postural deformity. Fiber type distribution does not appear to be related to the curvature in the same way.

Animals↗
PubMed1989

[Toxic skin reaction caused by hydantoins in a patient with AIDS].

A case of clinically characteristic hypersensitivity reaction to phenytoin in a AIDS patient with cerebral toxoplasmosis is reported. There was response to therapy with systemic steroids. Laboratory data and histopathologic features of the skin are reported.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Study of the secretion of pepsinogen I in cirrhotic humans with and without portacaval shunt.

Thirty-nine subjects have been studied: 14 with hepatic cirrhosis who had not been subjected to surgery, 13 cirrhotic patients in whom portacaval shunt had been performed, and 12 normal controls. In all of them, we performed serum determinations of pepsinogen I, both basal and after pentagastrin stimulation, and of basal gastrin levels, as well as analyses of basal and stimulated gastric acid secretion (basal acid output and maximal acid output). The values for pepsinogen I, basal or post-stimulation, were higher (p less than 0.001) in patients with cirrhosis who had not undergone surgical shunt than in those in the control group. However, there were no statistically significant differences when these two groups were compared with the patients who had been subjected to portacaval shunt. In this last group of patients, seven had levels similar to those of the controls, and six presented higher values. Likewise, the values for gastric acid secretion were similar in the three groups of patients, and the basal gastrin level was lower (p less than 0.001) among patients with liver cirrhosis, whether or not they had undergone surgery, than among the control population. In conclusion, the functional alterations of the gastric mucosa in patients with hepatic cirrhosis are not significantly different from those found in cirrhotic patients with portacaval shunt.

Adult↗
PubMed1987

Scoliosis induced by medullary damage: an experimental study in rabbits.

To date, there have been no reports of experiments designed to induce scoliosis by direct damage of different areas of the spinal cord. In a series of rabbits with medullary damage, the authors attempted selectively to interrupt the pathways that mediate proprioceptive input. Unilateral lesion of the dorsal column and posterior horn of the spinal cord was performed using three different techniques: coagulation with laser, stereotaxic microcoagulation, and longitudinal electrocoagulation. Of 32 operated rabbits, 17 developed scoliosis, exhibiting clear pathologic damage of the spinal cord. Electrophysiologic study, including EMG and analysis of the tonic -- vibratory reflex, was performed on 10 rabbits with medullary damage (scoliotic and non-scoliotic) and 12 matched controls. The data suggest disturbance of the sensory afferences that control the postural tone and consequent muscular imbalance, expressed as reduced activity in the muscles of the convex side. This work supports the view that loss of proprioceptive neural impulses caused by medullary damage can induce scoliosis.

Animals↗