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Biomedical subjects

D Blanco

Publications and source records attributed to D Blanco.

At least 37 records · Page 2Linked to original sources
PubMed1996

Effects of dexamethasone on retinal and choroidal blood flow during normoxia and hyperoxia in newborn piglets.

Our purpose was to study the effect of dexamethasone (DEX) on choroidal (ChBF) and retinal blood flow (RBF) during normoxia and hyperoxia. Eighteen spontaneously breathing newborn piglets were examined. ChBF and RBF were measured using radiolabeled microspheres while the piglets were in normoxia before (RA1) and 45 min after either saline or DEX (2 mg/kg) infusion (RA2), and after 90 min of hyperoxia (O2) (Pao2 40-60 kPa). Vitreous prostanoids (prostaglandins F1 alpha and E2 and thromboxane B2) and leukotrienes (leukotriene B4) measurements were obtained during normoxia after either placebo or DEX infusion in an additional 22 piglets. Vitreous prostanoids were also studied after 90 min of hyperoxia. We found that RBF increased significantly after DEX infusion (p < 0.02). There was no change in RBF from RA1 to RA2, before and after saline infusion. RBF decreased significantly during hyperoxia in both groups (p < 0.03). ChBF did not change significantly between RA1 and RA2 in any of the groups. ChBF decreased significantly during hyperoxia in both groups (p < 0.03). Vitreous prostanoids and leukotrienes were reduced significantly after DEX infusion (p < 0.05). Prostanoids were similar in the two groups during hyperoxia. We concluded that DEX increases RBF significantly, but not ChBF. RBF and ChBF decreased in both groups during hyperoxia. Therefore, the metabolites of arachidonic acid do not seem to be involved as mediators of hyperoxic vasoconstriction.

Animals↗
PubMed1995

Peribulbar anaesthesia: the role of local anaesthetic volumes and Thiomucase in motor block and intraocular pressure.

Peribulbar anaesthesia is a useful regional anaesthesia and akinesia technique for eye surgery. We studied changes in muscular akinesia and intraocular pressure under peribulbar anaesthesia caused by different volumes of 0.75% bupivacaine with or without the addition of Thiomucase (chondroitin sulphatase) in patients undergoing cataract surgery. A total of 120 patients were randomly allocated into four groups: group 1, bupivacaine 5 mL; group 2, bupivacaine 5 mL plus Thiomucase 10 U mL-1; group 3, bupivacaine 9 mL; group 4, bupivacaine 9 mL plus Thiomucase 10 U mL-1. We assessed: (1) akinesia according to mobility in the four quadrants of the eyeball and the palpebral opening using a scoring system between 0 (total akinesia) and 10 (full movement); and (2) intraocular pressure before, immediately after and 15 min after peribulbar anaesthesia. A significantly better motor blockade was observed in groups 2, 3 and 4 than in group 1 (P < 0.05). Thiomucase increased the quality of motor blockade in group 2, but not in group 4. Intraocular pressure increased by 5-10 mmHg in comparison with baseline values and, after 15 min application of Honan's balloon, decreased by 8-10 mmHg in comparison with baseline values, with no significant differences between groups. Thiomucase can improve the motor block if a lower volume of local anaesthetic is used. The administration of 5 or 9 mL volumes or the addition of Thiomucase decreases the the intraocular pressure in a similar way.

Aged↗
PubMed1993

Automated determination of total polyphenols in apple juice.

An automated method of total polyphenols analysis in apple juice using the Folin-Ciocalteu reagent is presented. Chlorogenic acid was selected as the standard since a similar kinetic behaviour, standard-sample, was observed. A straightforward method with good reproducibility (CV < 1%), sampling frequency (48 h-1) and correlation with the traditional batch method (r = 0.9924) is proposed.

Beverages↗
PubMed1992

Early neurological manifestations and brain anomalies in Marden-Walker syndrome.

We report on an infant with the Marden-Walker syndrome. In addition to the consistent neurological abnormalities described previously in this syndrome, the infant had a striking neurological constellation, absence of primitive reflexes, jerky eye movements, failure to habituate to repeated stimuli, inadequate behavior development, and absence of orientation responses to visual or auditory stimuli. Muscle biopsy showed a similar pattern to the congenital fiber-type disproportion. Ultrasonograms and magnetic resonance imaging of his brain demonstrated absence of corpus callosum, colpocephaly, hypoplastic brainstem, hypoplasia of the inferior vermis and of the cerebellar hemispheres. These findings further delineate this syndrome and suggest that prenatal central nervous system (CNS) dysfunction, mainly of the cerebellum and brainstem, may play a significant role in the pathogenesis of the Marden-Walker syndrome.

Abnormalities, Multiple↗
PubMed1984

Cholecystectomy and colonic cancer.

In a case-control study of cholecystectomy and carcinoma of the colon conducted in a residential retirement community near Los Angeles, California, no significant association was found, either for all colonic cancer (relative risk = 1.2) or by subsite (relative risk = 0.8 for right-sided colonic cancer and 1.3 for other colonic cancer). Because of this negative finding and the inconsistency of other epidemiologic studies, certain aspects of the descriptive epidemiology of colonic cancer in Los Angeles were examined to see if they were consistent with a major etiologic role for cholecystectomy. The distribution of right-sided colonic cancer by sex and race contrasted sharply with that expected, based on the known distribution of cholecystectomies in the population. Cholecystectomy is unlikely to be an important factor in the etiology of right-sided colonic cancer.

California↗
PubMedDate not supplied

[FICTION as a new tool to early lung cancer diagnosis].

Lung cancer is one of the most frequent causes of cancer death in Western countries. Overall 5-year survival rate is lower than 15% mainly due to the late diagnosis of the disease. Primary prevention (reduction of tobacco consumption) and more effective methods for early detection are needed. Some studies have recently shown that low-dose spiral computed tomography (CT) is a useful technique to the detection of pulmonary malignant nodules in early stages. Studies are developing to evaluate its efficacy in series of high-risk patients. A new cytogenetic technique has been developed: the FICTION technique (Fluorescence Immunophenotyping and Interphase Cytogenetics as a Tool for the Investigation of Neoplasms). This technique allows the simultaneous study of immunophenotypic markers and genetic abnormalities present in tumour cells. The goal of our project is optimise this technique in sputum and bronchoalveolar lavage specimens from lung cancer patients. The overall goal of this project is evaluate the usefulness of this technique, together with the new radiological techniques, in early detection programs of lung cancer in high-risk patients. In the present study we review the cytogenetic studies on lung cancer carried out in the recent years. We also introduce the basic methodological aspects that will be developed in our project.

English Abstract↗
PubMedDate not supplied

[Early assessment in perinatal hypoxia. Prognostic markers].

INTRODUCTION: Perinatal asphyxia and its neurological signs are the most important cause of brain damage and neurological sequelae in full term newborn babies. Neuroprotection treatments currently being investigated promise to reduce such sequelae, but these treatments are not without risk and the patients involved should be selected. OBJECTIVE: To analyze a scale composed of variables recorded from the start of delivery until the fourth hour of life, comparing the neurological evolution of the patients. By means of this scale we aim to establish a criterion for the selection of neonates with acute perinatal asphyxia, who would benefit from neuroprotector treatment. PATIENTS AND METHODS: A retrospective study was made of 50 patients with the diagnosis of perinatal asphyxia. Our scale was formed of the following variables: intrauterine meconiorrhexis, pathological cardiotocographic recordings, resuscitation at birth, Apgar score at five minutes, pH of the umbilical artery blood, neurological examination, multisystemic involvement, seizures, persistent metabolic acidosis and need for mechanical ventilation during the first hours of life. The patients were followed up for at least one year by means of periodical studies (neurological examination and evaluation of psychomotor development according to the Brunnet Lezinne test). For statistical analysis we used the chi squared test, Fisher's exact test, Kruskal-Wallis test and the area beneath the ROC curve. RESULTS AND CONCLUSIONS: The scale presented constitutes a rapid, easy method which is statistically significant for the selection of perinatal asphyxia of high neurological risk which would benefit from neuroprotector treatment after the event.

Acidosis↗
PubMedDate not supplied

[Comparative study of vecuronium and atracurium at low doses in minor pediatric surgery under combined anesthesia].

To compare, the time of onset and time of recovery of muscular blockade after use of half doses of vecuronium and atracurium, we studied 18 children ASA I who were proposed for short lasting pediatric surgery and combined anesthesia. Patients were divided into two groups: group V (n = 10) was treated with a single dose of 0.05 mg/kg of vecuronium and group A (n = 8) with 0.25 mg/kg of atracurium. Assessment of muscular relaxation was performed by measuring the electromyographic responses to a train of four stimuli applied to the cubital nerve at the level of the hypothenar eminence. We administered 0.02 mg/kg of atropine, 5 to 10 mg/kg of thiopental, and the muscular relaxing dose together with orotracheal intubation when the first stimulus of the train of four stimuli was blocked at 90% of its initial value (T90). Maintenance of the anesthetic level was performed with 50% of N2O-O2 without inhalational anesthetics. A caudal blockade was induced by 1 ml/kg of bupivacaine at 0.25%. We measured the following parameters of muscular relaxation: T90, T10 (time at which the 10% of the first stimulus reappears), T25 (time of clinical efficacy) and IR (index of recovery). Only 60% of patients (6 out of the 10 patients of vecuronium group and 5 out of the 8 subjects of atracurium group) achieved the T90. This occurred 2.5 +/- 0.7 min after vecuronium and 3.2 +/- 0.6 min after atracurium. T10 was 13.7 +/- 4.1 min for vecuronium and 13.3 +/- 4.1 min from atracurium. T25 occurred 18.2 +/- 6.5 min after vecuronium and 19.4 +/- 2.1 min for atracurium.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, Caudal↗
PubMedDate not supplied

Topography of peribulbar anesthesia.

BACKGROUND AND OBJECTIVES: Peribulbar anesthesia has fewer complications than retrobulbar anesthesia, but ocular perforation has also been described in peribulbar anesthesia. This study aims to verify by computed tomography that the recommended points for performing peribulbar anesthesia are safe. METHODS: Three human corpses were used. The puncture points were position A (superior internal orbital angle and inferior external orbital angle), position B (superior and inferior orbital median line), and position C (superior external and inferior internal orbital angle). Contrast diffusion was studied in each position at 3, 4, 5, and 10 minutes after contrast injection. RESULTS: Among upper eyelid punctures, the only one anatomically safe is the internal angle puncture, given that either in the median line or the external angle there is a chance of eye globe perforation. Lower eyelid positions are a safe distance from the optic nerve and ocular globe. Contrast diffusion was satisfactory in positions A and B. There was little diffusion in position C. CONCLUSIONS: The median or external superior angle eyelid puncture may cause eye globe perforation.

Anesthesia, Local↗
PubMedDate not supplied

[Utility of epidural catheterization by the caudal route in pediatric anesthesia].

OBJECTIVES: To compare analgesic effect of bupivacaine during and after surgery when delivered through a lumbar epidural catheter entering by the caudal route with either caudal or lumbar administration of anesthetic through the needle. PATIENTS AND METHODS: One hundred forty ASA I patients under 110 months undergoing infraumbilical surgery were studied. The children were distributed randomly into 3 groups: group 1, caudal puncture and anesthesia with 2.5 mg/kg bupivacaine 1:200,000; group 2, lumbar puncture at L4-L5 and 1.25 mg/kg of the same local anesthetic; and group 3, epidural catheter in the caudal space up to L4-L5 and 1.25 mg/kg of the same local anesthetic administered through the catheter (Minipack: SYSTEM 2-Portex). The patients were anesthetized with endovenous or inhalational anesthetics. Variables recorded were analgesia during surgery (hemodynamic constants) and afterwards (CHEOPS scale), level of cutaneous sensory blockade immediately after the operation and its relationship to age, complementary analgesia used and complications. X-rays of the distal end of the catheter were taken in group 3. RESULTS: Analgesia during and after surgery was sufficient for all patients in group 1. Two patients, 1 from group 2 and 1 from group 3, were eliminated due to lack of analgesia during surgery. The level of cutaneous sensory blockade attained was significantly lower in group 3 than in group 1, and only in group 1 were we able to establish a linear correlation between level of sensory blockade and age (R = 0.51; p < 0.01). In group 3, 85.5% of the catheters reached L4-L5. Complementary analgesia was similar in the three groups. Complications included 5 cases of blood loss at the point of puncture in groups 1 and 2, and 1 case of catheter penetration of the juncture in group 3. CONCLUSIONS: Epidural anesthesia by way of a catheter entering by the caudal space allows us to achieve intra- and postoperative analgesia of comparable quality to that afforded by a lumbar approach or a single direct caudal puncture.

Abdomen↗
PubMedDate not supplied

[Thoracic epidural anesthesia by the caudal route in pediatric anesthesia: age is a limiting factor].

OBJECTIVES: To evaluate the success and degree of difficulty of inserting an epidural catheter into the caudal space in order to place its distal end at T10 in young patients. PATIENTS AND METHODS: Forty-seven children up to 97 months old were studied. With the patients under general anesthesia with an orotracheal tube, a predetermined length of 18-G epidural catheter (Minipack: SYSTEM 2-Portex) was inserted to T10. X-rays were taken after surgery with 0.3 ml of iodine contrast. The catheter was considered well-placed if the distal end was between T10-T12; the approach was classified as easy, difficult or impossible. RESULTS: The catheter was placed at T12-T10 on 16 occasions: 6 in L1, 3 in L2, 4 in L3, 17 in L4-L5, and 1 in S1. T10-T12 was reached in 52% of patients under 1 year of age, but in only 17% of children older than 1 year. The L4-L5 epidural space was reached with 46 of 47 catheters. Advance was easy in 41 cases, with only 16 reaching the objective. Advance was difficult in 6 cases, with only 1 reaching L1 and none reaching T10-T12. All catheters were easily removed. CONCLUSIONS: It is not possible to guarantee the arrival of an 18-G epidural catheter to the thoracic epidural space by entering through the caudal route. In children over 1 year of age, the level of success decreases significantly. Easy advance of the catheter cannot be taken to be a sign of success.

Age Factors↗