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Biomedical subjects

D Amato

Publications and source records attributed to D Amato.

104 records · Page 6Linked to original sources
PubMedDate not supplied

Increments in whole body bone mineral content associated with weight and length in pre-term and full-term infants during the first 6 months of life.

BACKGROUND: The objective of the present study was to assess bone mineral content (BMC) of the whole skeleton in pre-term and full-term healthy infants and the factors influencing BMC, such as bone area, birth weight, birth length, current weight, current length, gender, and gestational age. METHODS: Forty-eight healthy full-term infants and 34 healthy premature infants fed predominantly with intact human milk were studied. BMC was measured monthly with dual energy X-ray absorptiometry (DEXA). At the same time, length and weight were measured and registered. Pre-term infants were studied at 60-day intervals. RESULTS: For both full-term and pre-term infants, BMC increased during the first months of life. However, the values of pre-term infants never reached the values of full-term infants, even after correcting for age and weight. For both full-term and pre-term infants, BMC was significantly correlated at the second month with birth weight (r = 0.901), birth length (r = 0.860), gestational age (r = 0.803), bone area (r = 0.960), current weight (r = 0.920), and current length (r = 0.840, p <0.001 for all correlation coefficients). Multivariate analysis revealed that bone area was the most important factor in predicting BMC. CONCLUSIONS: Pre-term children have lower BMC than full-term children. The main factor explaining this apparent osteopenia is bone area. Pre-term children have a higher daily mineralization rate than full-term children, but this catch-up mineralization is not enough to reach BMC levels seen in full-term children.

Absorptiometry, Photon↗
PubMedDate not supplied

[A rare complication of the Greenfield vena cava filter].

The authors report an unusual case of retroperitoneal haemorrhage following the application of a Greenfield modified titanium filter: haematoma due to the lesion of a lumbar vein was favoured by anticoagulant therapy and complicated by infection, ending in frank disruption of the vein wall. A review is made of the modalities of caval penetration and perforation with the Greenfield filter.

Aged↗
PubMedDate not supplied

[Parathyroid cysts: comments apropos a case].

A case of non-functioning parathyroid cyst is reported, in which the preoperative diagnosis was missed. A careful review of the pertinent literature allows to outline the correct approach to this rare pathology as for the diagnosis and the treatment; as well, to enlight the current controversies about the physiopathology and the pathology.

Cysts↗
PubMedDate not supplied

Correlation between peritoneal equilibration test and dialysis adequacy and transport test, for peritoneal transport type characterization. Mexican Nephrology Collaborative Study Group.

OBJECTIVE: The aim of this study was to analyze the correlation between the peritoneal equilibration test (PET) and the dialysis adequacy and transport test (DATT) for peritoneal transport type characterization, and the degree of patients' acceptance for each test. DESIGN: Cross-sectional, observational multicenter study. SETTING: Five referral (tertiary) dialysis centers of institutional practice. PATIENTS: The study included 107 adult continuous ambulatory peritoneal dialysis (CAPD) patients with a prescription of four exchanges of 2 L per day, irrespective of age, gender, cause of end-stage renal disease, time on dialysis, nutritional status, or residual renal function. Patients on immunosuppressive therapy and those with cancer, hepatitis B, or HIV, and those having a peritonitis episode within the previous 30 days, or three or more episodes during the previous 12 months, were excluded. MAIN MEASURES: Peritoneal transport type as classified by creatinine and urea dialysis-to-plasma (D/P) ratios by PET and DATT. RESULTS: Correlation coefficients between D/P ratios for creatinine and urea, obtained for the PET and the DATT, were 0.73 for D/P creatinine and 0.96 for D/P urea. Patients were classified into high, high-average, low-average, and low transport categories according to the mean and standard deviation of D/P creatinine values obtained from the PET at 4 hours. These values showed excellent concordance with those generated from the DATT data (alpha = 0.82, 95% confidence interval 0.67 - 0.93). Nineteen percent of patients showed discordance in their category when classified according to the PET versus the DATT. Patients' acceptance was better for the DATT than for the PET, as evaluated with a questionnaire. CONCLUSION: The DATT is an easy, inexpensive, and reliable test to assess peritoneal transport type, and it also provides information about peritoneal clearance of solutes and ultrafiltration. The DATT has better patient acceptance than the PET. Since the DATT has only been validated for patients on a fixed CAPD daily schedule of 4 x 2 L, the results should be confined only to patients receiving such a prescription.

Adolescent↗
PubMedDate not supplied

Relationship between fill volume, intraperitoneal pressure, body size, and subjective discomfort perception in CAPD patients. Mexican Nephrology Collaborative Study Group.

OBJECTIVE: To determine changes in intraperitoneal pressure (IPP) when dialysate fill volume is increased from 2.0 L to 2.5 L to 3.0 L per exchange, and to evaluate the relationship with subjective discomfort perception. DESIGN: Cross-sectional survey. SETTING: Seven Mexican hospital-based dialysis centers. PATIENTS: Eighty-one adult patients on continuous ambulatory peritoneal dialysis (CAPD) without restriction criteria for age, gender, or time on dialysis, were studied. Patients seropositive for HIV or hepatitis B, and those with cancer or receiving immunosuppressive drugs were excluded. Participants were studied as outpatients. MAIN MEASURES: Blindly and in random order, 2.0-, 2.5-, and 3.0-L volumes of dialysate were infused consecutively. Body surface area (BSA) was calculated from patient height and weight. IPP was assessed with the patient lying supine, measuring the height of the dialysate column inside the peritoneal dialysis bag tubing. Blood pressure and subjective discomfort perception (using a visual analog scale of 0-100 mm) were also evaluated and registered after each of the three exchanges. RESULTS: The IPP rose with each increase of dialysate volume and was higher in males than in females for each fill volume level. For males IPP was 18.9 +/- 6.9, 20.8 +/- 7.1, and 22.9 +/- 7.5 cm H2O; and for females it was 16.5 +/- 5.7, 18.4 +/- 5.5, and 19.7 +/- 6.2 cm H2O for 2.0-, 2.5-, and 3.0-L fill volumes respectively (p < 0.01 among fill volumes and between genders). Intraperitoneal pressure showed significant negative correlation with the fill volume corrected for patient body size as reflected by the dialysate volume/ BSA ratio (r= -0.393, p < 0.01; r= 0.319, p < 0.01; and r= -0.274, p < 0.02 for 2.0-, 2.5-, and 3.0-L fill volumes respectively). Discomfort score rose as fill volume rose, with a median of 0, 2.5, and 13.0 for 2.0-, 2.5-, and 3.0-L fill volumes respectively (p< 0.001). It is interesting, however, that with 2.5-L and 3.0-L dialysate infusion volumes, 64% and 44% of the patients, respectively, had no discomfort at all. CONCLUSION: Dialysate volume increase is associated with higher IPP, which is modulated by the gender and body size of the patients. Although the mean discomfort score was higher with larger dialysate volumes, there was no significant correlation between discomfort and IPP or the dialysate volume/BSA ratio. Many patients had no discomfort with 2.5-L or even with 3.0-L dialysate infusions; theoretically, they can be treated with larger volumes.

Adult↗
PubMedDate not supplied

[Cost-effectiveness analysis of ceftriaxone and cefotaxime in the treatment of community-acquired pneumonia].

OBJECTIVE: To assess the cost-effectiveness ratio of ceftriaxone and cefotaxime to treat moderate to severe community acquired pneumonia (CAP). METHODS: A clinical trial was done in five hospitals of the Instituto Mexicano del Seguro Social, at the metropolitan area of Mexico City. Ceftriaxone and cefotaxime were compared to treat moderate to severe CAP, and the costs of purchasing, preparation, administration, hospitalization, and therapeutic success were quantified. Cost-effectiveness ratio was calculated, and sensitivity analysis and incremental analysis were done. RESULTS: The main isolated germs were Streptococcus pneumoniae (23.6%) and Staphylococcus aureus (18.5%). Most of the microorganisms were sensitive to ceftriaxone, ceftazidime, and cefotaxime, and were resistant to penicillin, ampicillin, and erythromycin. Therapeutic success was 98% in the ceftriaxone group and 83% in the cefotaxime group (p = 0.0091). Cost-effectiveness ratio for per cent unit of success was $19,458.62 Mexican pesos in the ceftriaxone group and $29,218.08 in the cefotaxime group. Sensitivity analysis showed consistently a lower cost-effectiveness ratio in the ceftriaxone group. Incremental analysis based on the treatment of 55 patients showed that using ceftriaxone instead of cefotaxime resulted in saving $35,170.79 per each additional cured patient. CONCLUSIONS: Ceftriaxone has a lower cost-effectiveness ratio than cefotaxime to treat patients with CAP and bad prognosis criteria requiring hospitalization.

Cefotaxime↗
PubMedDate not supplied

[Cryo-treated allo-prosthesis: applications and complications].

From January 1987 to December 1992, fifty two patients aged 1 day to 20 years were implanted cryo-treated homografts into the right-sided position. The patients were diagnosed as having severe Fallot's tetrads, common arterial trunk, transposition of great vessels, vascular bifurcation with pulmonary atresia and isolated pulmonary atresia. The authors implanted 56 homografts, out of them 37 aortic and 19 pulmonary. In the early postoperative period 8 (15.4%) patients died whereas in the late period 1 (1.92%) patient. Out of complications, pseudoaneurysm, calcification with pseudoaneurysm, flap dilatation, and severe prosthesis calcification were found in 1, 1, 1, and 4 patients, respectively. The development of pseudoaneurysms is likely to result from incorrect treatment of donor tissue and to be not so infrequently as previously assumed. To prevent their development is to apply accessory individual sutures to the gaskets in the area of the anterior wall of proximal anastomosis and to use the Gore-Tex material for an external flap.

Adolescent↗
PubMedDate not supplied

Epidemiologic and demographic aspects of peritoneal dialysis in Mexico.

OBJECTIVE: To assess some epidemiological and demographic aspects of peritoneal dialysis (PD) at the Instituto Mexicano del Seguro Social (IMSS), the major institution of social security in Mexico, that provides health care services for 57% of the Mexican population at the time of the study. STUDY DESIGN: A cross-sectional analysis of data about patients under peritoneal dialysis in 1992. DATA SOURCES: A national survey containing demographic data, dialysis modality, type of catheter, peritonitis and death rates, and questions on costs, medical staff, and physical facilities for PD in all of the hospitals of the IMSS. RESULTS: All hospitals returned the information requested. Intermittent peritoneal dialysis (IPD) was performed in 19 hospitals, continuous ambulatory peritoneal dialysis (CAPD) in 11, and both modalities in 90. In 61 hospitals, a special area was designed for PD; in the rest of them, beds from general internal medicine departments were used. All hospitals had a head for the PD programs; overall, teams had 240 physicians and 765 nurses for IPD, and 182 physicians and 313 nurses for CAPD. CAPD prescription was four 2-L bags/day. For IPD, patients were hospitalized once a week and received 28 manually performed exchanges of 2-L bags; the mean time of hospitalization was 2.7 days, and 878 beds were used. The number of patients receiving PD was 7785, with a prevalence of 199.6 per million population. Of them, 4011 were on IPD and 3774 on CAPD; 54% of the patients were males. IPD patients' mean age was 49 +/- 17 yr, and that of CAPD patients' was 42 +/- 17 yr (NS). Diabetic nephropathy was the most frequent cause of ESRD (44%). Infection was the most important complication detected. Rates of peritonitis were 0.5/patient/yr on IPD and 0.8/patient/yr on CAPD. Annual mortality rates without stratification for specific causes were 34% in IPD and 17% in CAPD. Mortality rates may have been influenced by malnutrition and cardiovascular complications of diabetes, but specific causes of death were not investigated. All of the PD programs costs were covered by the institution. The cost per patient was not calculated, but IPD is known to be more expensive, due to its higher hospitalization rate. CONCLUSION: In spite of its higher cost and mortality, the institutions still use IPD, not so much on medical basis, but as the only alternative available for patients with adverse environmental, social, educational, and economic conditions for CAPD or HD.

Adolescent↗
PubMedDate not supplied

In vitro effect of complete Staphylococcus aureus extract on chemotaxis of polymorphonuclear cells in children with bronchial asthma and chronic relapsing upper airways infections.

UNLABELLED: Chemokinesis and chemotaxis were measured in polymorphonuclear cells (PMN) from 51 children aged 1 to 8 years old, of either sex. Case group--41 non-allergic asthmatic children with chronic relapsing upper airways infections, diagnostic criteria were history of wheezing associated to an upper airways infection episode and negative skin tests. CONTROL GROUP: 10 healthy children. A sample of 10 ml of peripheral venous blood was drawn. PMN were incubated with Hank's solution to measure chemokinesis and with C5a and Staphylococcus aureus extract to measure chemotaxis. Chemokinesis values in healthy control children and in patients with non-allergic bronchial asthma were of 46.0 +/- 7.1 vs 23.8 +/- 6.1 microns (p < 0.01). C5a-stimulated chemotaxis values in healthy control children and in patients with non-allergic bronchial asthma were of 91.0 +/- 21.3 vs 92.3 +/- 21.0 microns (ns), and Staphylococcus aureus extract-stimulated chemotaxis values in healthy control children and in patients with non-allergic bronchial asthma were of 97.0 +/- 22.4 vs 92.0 +/- 23.0 microns (ns). These results suggest that PMN from children with non-atopic asthma have reduced chemokinesis. After a chemotactic stimulus with C5a and bacterial extract, leukocyte motility is corrected and reach similar values to that present in healthy children.

Chemotaxis, Leukocyte↗
PubMedDate not supplied

[Soft-drinks and health].

OBJECTIVE: To analyze published papers about soft drinks use, and to describe possible health benefits, risks, and damages related to soft drink consumption. INFORMATION SOURCE: A search was done in the MEDLINE compact disks, from January 1970 to January 1997, with the keywords soft drink, beverages, carbonated beverages, cola, Coca-Cola and sweetening-agents. STUDY SELECTION: Ninety nine papers reporting health-related damages or benefits in clinical or experimental studies were reviewed. DATA EXTRACTION: All articles with a clear description of at least one beneficial or harmful effect related to soft drink consumption were considered. RESULTS: There were reports on 25 harmful effects and of 7 possibly beneficial effects. Data are classified in prophylactic and therapeutic uses, dental caries and other dental disorders, mineral metabolism disorders, acid-peptic disease, neoplasm, risk factors for cardiovascular disease, effects on central nervous system, reproduction, allergy, and miscellaneous. CONCLUSIONS: High prevalence of exposure and excessive consumption of soft drinks may represent a public health problem in Mexico. Data analysis shows that soft drink consumption may not be as harmless as generally believed. Many of the reports are anecdotal, without a suitable methodological design. A wide field for research is present in this area.

Caffeine↗
PubMedDate not supplied

Acute effects of soft drink intake on calcium and phosphate metabolism in immature and adult rats.

OBJECTIVE: To test the acute effects of the intake of a phosphoric acid containing soft drink on acid-base balance and on calcium and phosphate metabolism. MATERIAL AND METHODS: We studied 14 young adult male Sprague-Dawley rats aged 90 days, and 14 immature animals aged 30 days. Half of the animals in each group were randomly assigned to receive either tap water (controls), or Coca-Cola ad libitum for seven days. After this period, the rats were individually placed in metabolic cages to collect 24 hours urine, and they were exsanguinated by aortic puncture. Immediately, pH and ionized calcium were measured in whole blood. Creatinine, phosphate and total calcium were determined in the urine and plasma. Plasma levels of PTH, 1 alpha, 25 (OH)2 D3 and 25 OH D3 were measured by IRMA and RIA commercial kits. RESULTS: The animals receiving the soft drink, both adults and immature, developed significant hypercalciuria and hyperphosphaturia. In immature animals, the plasma pH dropped from 7.45 +/- 0.04 to 7.33 +/- 0.02 (p < 0.05) but did not change in adult animals. Ionized calcium dropped significantly from 1.06 +/- 0.04 to 0.80 +/- 0.06 meq/L (p < 0.05) in immature animals but not in the adult animals. Only immature rats developed significant reduction of 1 alpha, 25 (OH)2 D3 and 25 OH D3, whereas only the adult rats developed significant hyperparathyroidism. Immature animals showed more severe derangement of calcium and phosphate metabolism related to soft drink intake.

Acid-Base Equilibrium↗