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Biomedical subjects

D Bagilet

Publications and source records attributed to D Bagilet.

15 recordsLinked to original sources
PubMed2002

[Preoperative diclofenac does not reduce pain of laparoscopic cholecystectomy].

OBJECTIVE: To study the safety and efficacy of diclofenac for preemptive analgesia in the first 24 hours after elective laparoscopic cholecystectomy (ELC). PATIENTS AND METHODS: This prospective, randomized, placebo-controlled, double-blind study enrolled 90 patients of both sexes undergoing ECL. The patients were 17 to 76 years old and weighed between 45 and 100 Kg (ASA I and II). Assignment was to one of the following groups. A control group received diclofenac before and after surgery (DD) as follows: diclofenac 1 mg/Kg i.m. 60 minutes before surgery and a loading dose of 0.35 mg/Kg i.v. after surgery followed by continuous infusion of 1.5 mg/Kg over 24 hours. The study group received diclofenac and placebo (DP) as follows: diclofenac 1 mg/Kg i.m. 60 minutes before surgery and infused saline solution after extubation. A second control group received placebo before surgery and diclofenac afterwards (PD) as follows: a physiological solution was given intramuscularly 60 minutes before the operation and diclofenac was given after extubation as in the DD group. Pain intensity was assessed on a visual analog scale at four times: 1 hour (T1), 6 hours (T2), 12 hours (T3) and 24 hours (T4) after extubation. At those times we also recorded the need for rescue analgesia and side effects. Arterial blood gases and vital signs were recorded 1 hour before surgery (T0) and at T4. RESULTS: Pain intensity at T1 was 2.67 +/- 0.54, 2.82 +/- 0.63 and 2.88 +/- 0.58 for the DD, DP and PD groups, respectively (p = 0.96). The differences in mean pain between T1 and T2, T3 and T4 were -0.2 +/- 0.66, -0.7 +/- 0.51 and 0.0 +/- 0.72 in the DD group (p = 0.723); -0.9 +/- 0.60, -0.4 +/- 0.57 and -1.3 +/- 0.65 in the DP group (p = 0.578); and -1.0 +/- 0.59, -0.5 +/- 0.77 and -1.0 +/- 0.69 in the PD group (p = 0.816). No significant differences in pain intensity or need for rescue analgesia were observed. Although 22 side effects were observed in group DD, 21 in DP and 21 in PD, none was serious. CONCLUSIONS: Simple preemptive analgesia with 1 mg/Kg i.m. of diclofenac 60 minutes before induction of anesthesia does not decrease pain intensity or the need for rescue analgesia in the first 24 hours after ELC.

Adolescent↗
PubMed2000

[Oral levofloxacin versus intravenous ceftriaxone and amoxicillin/clavulanic acid in the treatment of community-acquired pneumonia that requires hospitalization].

BACKGROUND: Levofloxacin, an antibiotic from the quinolone family, which is used with success in the ambulatory treatment of patients with community-acquired pneumonia, has been recently introduced to the pharmaceutical market. The purpose of this study was to compare the effectiveness and tolerance of oral (v.o.) levofloxacin (LVF) versus intravenous (i.v.) amoxicillin/clavulanate (AMX/CL) and ceftriaxone (CTX) in the treatment of the community-acquired pneumonia that require hospitalization (CAPH). PATIENTS AND METHOD: In this prospective and randomized study 84 patients were included, 28 per group, from both sex with CAPH. The patients were assigned randomly to receive one of the next treatments: AMX/CL, 1.02 g i.v. every 8 h, CTX, 1 g i.v. every 12 h or LVF, 500 mg v.o. every 24 h. At the beginning clinical, biochemical and radiological characteristics were recorded from each case and at the 72 h the effect of treatment was evaluated using the evolution of the thermal curve and radiological images. The quantitative variables were analyzed with ANOVA, the qualitatives parameters with *2 test and Yates correction. The level of signification was * = 0.05. RESULTS: Age, sex, clinical presentation, biochemical measurements and radiological images in the 3 groups were similar and no adverse effects were recorded in any of them. Number of patients with favorable outcome in the groups AMX/CL, CTX and LVF was 25 (89%), 25 (89%) and 26 (93%); p = 0,870. CONCLUSIONS: Levofloxacin can be a simple, effective and safe therapeutic option for patients with CAPH.

Administration, Oral↗
PubMed2000

[Effect of topical and oral diclofenac on superficial thrombophlebitis caused by intravenous infusion].

BACKGROUND: Until present time, suggested treatments for superficial thrombophlebitis induced by intravenous infusion (TFSI), are of uncertain effectiveness and most of them or empirical and not fully researched. The aim of this report is to study the effectiveness and safety of the topical and oral administration of diclofenac in the treatment of TFSI. PATIENTS AND METHODS: In this prospective study 120 patients both female and male were included. All of them developed TFSI during hospitalization and at the same time they were assigned at random to one of the following groups: G-control (n = 40), without treatment; G-topical (n = 40), diclofenac emulsion gel used in a topical way on the concerned area every 8 hours during 48 hours; G-oral (n = 40), diclofenac 75 mg p.o. every 12 hours during 48 hours. The measurements were done at the moment of diagnosis of TFSI (T0) and 48 hours later (T2). Registries of intensity of TFSI were done by quantifying flushing, tumor, heatness and pain. These data were compared considering the averages of differences registered in T2 with respect to T0. A decrease of intensity of TFSI > or = 30% was considered a positive answer to this treatment. The quantitative variables were studied with ANOVA, Kruskal-Wallis test or general linear model and the qualitative with the chi 2 test with Yates correction. The level of significance used was alpha = 0.05. RESULTS: The averages of differences in the intensity of TFSI that were registered in the groups G-control, G-topical and G-oral in T2 compared to T0 are: -0.12 (4.89), -5.70 (3.13), -4.82 (3.14) (p = 0.000). The favorable answers in G-control, G-topical and G-oral were: 20, 60 and 60%, respectively (p = 0.0001). The adverse reactions in G-topical and G-oral were: headache 9-5 (p = 0.2), epigastric pain 4-17 (p = 0.0009), nausea 6-16 (p = 0.01) and local pruritus 5-2 (p = 0.2). The treatment did not report serious adverse reactions in either of the groups. CONCLUSION: The topical treatment of diclofenac can be recommended as an alternative simple, effective and safe therapy for patients who develop TFSI.

Administration, Oral↗
PubMed1999

[Evaluation of two methods to avoid the nephropathy associated with radiologic contrast].

UNLABELLED: Our objective was to establish the efficacy of two methods to avoid contrast associated nephropathy (C.A.N). We studied in prospective and randomized form a sample of 75 patients of whom 25 were assigned to the CONTROL GROUP: without interventions; 25 to the Saline group: 0.45% saline solution I.V., 1.5 cc/kg/min, 6 hours before and after the angiographic study and 25 to the Dopa group: equal procedure plus the aggregate of dopamine 2 micrograms/kg/min, 30 minutes before the study until the termination. The evaluation effected at patient's entry was considered T0, T1, 24 hs after the T2, 48 hs after. In T0 was registered: age, sex, pathological antecedents, drugs and plasmatic creatinine, and in T2 creatinine. An increase of 25% of the plasmatic creatinine in T2 was considered as C.A.N. The latter was present in 13/25 (OR: 1) CONTROL GROUP patients, 7/25 (OR 0.36), Salina group patients and in 5/25 (OR 0.23) Dopa group patients (p = 0.01). No significant difference was registered in the urinary output nor in the plasmatic creatinine levels. It is concluded that hydration during six hours before and after the study with 0.45% saline solution and the same plan with the aggregate of dopamine are effective to prevent a C.A.N.

Acute Kidney Injury↗
PubMed1999

[Intestinal infarct caused by giant cell arteritis].

Arteritis of giant cells compromising extracranial and particularly intestinal tissues is not frequent. Therefore, it is common practice to make the diagnosis retrospectively after analyzing the surgical sample. A case is presented of an 83 year old woman admitted to the Clinical Department with a clinical course of 3 days of evolution characterized by fever and pain in the left hemiabdomen. Her personal medical history included multiple diverticulosis of colon, collecistectomy and appendicectomy. Laboratory tests showed that uremia was 0.75 g/L (N.L to 0.45 g/L), V.E.S. 90 mm at the first hour, and the rest of the determinations were normal. The chest and abdomen rays as well as the abdomen and pelvis ecographies were normal. A diagnosis was reached as acute diverticulitis and the patient was treated with 400 mgr of ciprofloxacina and 2,000 mgr a day of metronidazol. She continued in a feverish state and with abdominal pain, so that an anexial tomography of abdomen was taken. It showed a widening of peritoneal fascias with scarce liquid in the left parietocolic dripping and Douglas septum. After 96 hours, surgery exploration was done and injuries in the left colon revealed compatibility with an infarct of the colon which had to be extirpated. Pathological examination revealed an infarct of colon due to a secondary arterial thrombosis characteristic of giant cell arteritis. After the diagnosis, immunological studies and biopsy of the left temporal artery were performed and reported as normal. The patient was treated with 40 mgr of prednisone a day improving rapidly.

Aged↗
PubMed1993

[Nalbuphine. Comparison of 2 therapeutic regimens for the control of postoperative pain].

The therapeutical efficiency and the undesirable effects of Nalbuphine administered to control postoperative pain were compared. Two groups of patients were studied: one group received 10 mg endovenously every 4 h during the first 12 h of the postoperative phase and every 6 h during the following 12 h while the other group received 20 mg with the same intervals. The following variants were evaluated: pain, systolic arterial tension, cardiac frequency, respiratory frequency and undesirable effects. After statistical analysis, a similarity in both groups was confirmed for pain, systolic arterial tension, cardiac frequency, while a significant difference was found in two of the undesirable effects: sedation and sweating. In conclusion, the 10 mg dose is as effective as that of 20 mg to control pain and has less unwanted effects.

Adult↗
PubMed1990

[Angioimmunoblastic lymphadenopathy and colonic lymphoma].

Angioimmunoblastic lymphadenopathy (AILD), first discovered in the 70's, is an infrequent disease which generally proves fatal within a short time. It is characterized by lymphadenopathies, hepatosplenomegaly, fever and rash. The most frequent laboratory findings are: anemia, leukocytosis with lymphopenia and non specific hypergammaglobulinemia. In spite of being considered a non malignant disease, it produces important immunity disorders which predispose the patient to serious infections, frequently fatal. In the course of time patients are likely to develop malignant lymphomas or other types of tumors. We describe a ganglionar proliferation and general symptoms in a patient who had been diagnosed as AILD by ganglionar biopsy. She was treated with corticosteroids during 8 months after which she had a complete recovery. Three months later the patient was readmitted with enterrorhagias and clear deterioration of her general condition. Tests showed the existence of a colon tumor and absence of adenomegaly in the areas previously affected by AILD. A colon surgery was carried out and a specimen examined. The anatomopathologic examination confirmed the existence of an immunoblastic lymphoma infiltrating the regional ganglionar area. Colon lymphomas constitute only 4% of all colon tumors; they are related to chronic gastrointestinal disease such as Crohn disease, ulcerative colitis, malabsorption syndromes, tumors and others. We conclude that in this patient AILD and prednisone administration constituted favoring factors for the development of an extranodal lymphoma.

Aged↗
PubMed1989

[Retroperitoneal liposarcoma. Clinico-pathological analysis of 6 cases].

Six patients with retroperitoneal liposarcoma are reported. Their mean age was 58,66 years. There were four males and two females. The symptoms or signs at presentation were: abdominal mass (5 cases); abdominal pain (3 cases); sustained fever (2 cases), and lower limb edema (1 case). Abdominal computed tomography (CT) showed large masses with different density. Distant metastases were not documented. All patients underwent laparotomy, and the tumor was not resectable in 2 cases. In the histological study, liposarcoma was shown to be myxoid in 4 cases, pleomorphic in one and round cell type in the remaining case. In 3 patients local relapse was observed. The longest survival was 38 months and the shortest one 3 months. It was concluded that the leading cause for consultation in these patients was an abdominal mass. Remarkably, two patients had the uncommon feature of sustained tumoral fever. CT was shown to be the most useful diagnostic method. The good general condition of the patients with large tumoral masses was remarkable. The most common variety was myxoid, local relapse was frequent and the survival was poor.

Adult↗