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Biomedical subjects

E Olea

Publications and source records attributed to E Olea.

At least 19 recordsLinked to original sources

Pharmacokinetics and tissue distribution of intravenous pefloxacin for antibiotic prophylaxis in biliary surgery.

The plasma levels and tissue penetration of pefloxacin were studied after prophylactic administration to patients undergoing elective biliary surgery. Pefloxacin was administered as a single dose of 800 mg given intravenously as an infusion 1 h before surgery. Over a period of two years, cultures of bile and stone were performed after cholecystectomy in order to find the main pathogens present in the geographical area of the hospital of Txagorritxu (Vitoria, Spain), as well as to test the antimicrobial susceptibility of these bacteria to pefloxacin. Thirty seven per cent of the bile and stone cultures were positive, and 75 different species were isolated. E. coli was the predominant microorganism (25%). Other frequent microorganisms were E. faecium (9.3%), S. epidermidis (6.6%) and Cl. perfringens (6.6%). Most species isolated were susceptible to pefloxacin, with MIC(90) values of 0.125 microg/ml for E. coli, 0.5 microg/ml for S. epidermidis and 1 microg/ml for Cl. perfringens. E. faecium was resistant, with a MIC(90) value of 8 microg/ml but a MIC(50) of 4 microg/ml (intermediate). After pefloxacin infusion, adequate drug plasma levels (>MIC(90)) for the most frequent pathogens were found throughout the procedure. Elimination half-life was estimated as 22.03+/-6.91 h; the area under the concentration-time curve from zero to infinite had a value of 275.07+/-130.02 mg h/l and the values for volume of distribution at steady-state and plasma clearance were 96.48+/-28.65 L and 3.60+/-1.83 l/h, respectively. Bile pefloxacin concentrations generally exceeded the minimum inhibitory concentrations for most relevant pathogens. Drug levels in gallbladder and subcutaneous tissues were also above the MIC(90) for extended periods. Patients were observed daily throughout their hospital stay. This included examination of the surgical wound and recording of body temperature. No cases of anaerobic infection were noted in the study patients. Other constants such as hospitalization stay and time of recuperation were normal for this type of surgery. According to these results, pefloxacin presents many features that make it suitable for use as a therapeutic prophylactic agent, such as its broad spectrum of antimicrobial activity and favorable pharmacokinetic properties.

Adult↗

[99mTc red blood cell scintigraphy for the assessment of active gastrointestinal bleeding].

BACKGROUND: 99mTc red blood cell scintigraphy is a non invasive diagnostic method for low flow gastrointestinal bleeding. AIM: To assess the diagnostic yield of this method in patients admitted with gastrointestinal bleeding in whom upper gastrointestinal endoscopy was negative. PATIENTS AND METHODS: The clinical records of 59 patients, aged 6 to 90 years old (35 male), with active gastrointestinal bleeding subjected to a 99mTc red blood cell scintigraphy were reviewed. All had non diagnostic upper gastrointestinal endoscopic studies, and in 20 a selective arteriography was performed. RESULTS: In 40 patients the scintigraphy was positive for gastrointestinal bleeding, and in 57% of these the exam was positive during the first hour. Fifteen of the 19 patients with a negative scintigraphy did not have an active clinical bleeding at the moment of the examination. In 24 patients, a final etiological diagnosis was reached. In 93% of these patients scintigraphy correctly identified the bleeding site. In one patient with a negative scintigraphy, angiography disclosed a pseudo aneurysm of the splenic artery that was not bleeding actively. CONCLUSIONS: In these patients with negative upper gastrointestinal endoscopy 99mTc red blood cell scintigraphy had a 91% sensitivity for the diagnosis of active gastrointestinal bleeding.

Adolescent↗

[Cardiovascular effects of AV interval shortening with electrical stimulation in dilated cardiomyopathy].

BACKGROUND: A temporal alteration between atrial and ventricular contraction, in which the last one would be abnormally retarded, could exist in patients with dilated cardiomyopathy. This alteration could have adverse hemodynamic effects. AIM: To study the hemodynamic modifications caused by an artificial shortening of AV interval in patients with dilated cardiomyopathy. PATIENTS AND METHODS: Nine patients with dilated cardiomyopathy were studied. Hemodynamic and tissular perfusion values, echocardiographic and radioisotopic ventricular function parameters were measured before and after six hours of AV interval shortening with electrical stimulation of the heart. RESULTS: After electrical stimulation, cardiac output increased from 3.38 +/- 0.8 to 3.87 +/- 0.79 l/min (p< 0.05). Pulmonary capillary pressure decreased from 23.8 +/- 8.9 to 19.8 +/- 9.2 mm Hg (p = NS). There were no significant changes in ventricular function parameters or in systemic and pulmonary pressures. CONCLUSIONS: Electrical shortening of AV interval in patients with dilated cardiomyopathy increases cardiac output but does not change ventricular function parameters.

Adult↗

[Functioning and non-functioning parathyroid cysts: entities with different origin and clinical characteristics in 2 cases].

We report two women presenting with parathyroid cysts. A 20 years old woman presented with goiter and a cystic lesion in the left thyroid lobe was identified on ultrasound examination and CAT scan. The patient had hypercalcemia and elevated PTH levels. The content of the cyst, obtained by needle aspiration, had an extremely high PTH concentration. The patient was operated, removing the cyst and a remaining thymus. Pathological study confirmed the diagnosis of a parathyroid cyst. An 11 years old girl presented with a mass in the left thyroid lobe. An ultrasound examination disclosed the presence of a cystic nodule. The patient was otherwise asymptomatic and laboratory work up was normal. The patient was operated and pathological examination of the surgical piece revealed a parathyroid cyst.

Adult↗

[Thyroid neoplasm of mid follicular-medullary type; an uncommon, particular and aggressive form: report of 3 cases].

Mixed medullary and follicular carcinoma of the thyroid shares secretory and immunohistochemical features of both follicular and parafollicular thyroidal cells. We report three women, aged 34, 63 and 61 old with this type of tumor. Its diagnosis must be bore in mind in patients with thyroidal tumors and a histological appearance of a medullary or undifferentiated carcinoma. An early diagnosis of a mixed medullary and follicular carcinoma of the thyroid is important, considering its special treatment and negative prognosis.

Adenocarcinoma, Follicular↗

[Nationally produced 153SmEDTMP in the palliative treatment of metastatic bone cancer pain].

153SmEDTMP was obtained from enriched 152Sm irradiated at the 5 MW Chilean Research Reactor and labelled at a molar ratio of 15:1 pH 7.5. Biodistribution, autoradiography, radiochemical purity tests were done for evaluation. 40 patients were treated with 37-55 MBq/kg weight. Bone scans using 99mTcHMDP were obtained prior and after treatment. Bone marrow depression was observed in 37% of them and normal liver function in all of them. In 45% the pain dissapear completely, in 22.5% significantly decreased and partially in 30%. In 17 patients more than one dosis was injected. Our preliminary results indicate that 153SmEDTMP is a promising radiotherapeutic agent for palliative treatment of metastatic bone cancer pain and encourage its use specially because it can be produced in countries with low economic resources, thus a large number of patients can get the benefits of this new procedure.

Adult↗

[Multiple endocrine neoplasia type 2A. Report of a case with an unusually aggressive outcome].

We report a 28 years old woman who consulted for diarrhea of two years and a thyroid nodule. A medullary thyroid carcinoma was diagnosed and a thyroidectomy performed. There was a local relapse two months later and distant metastases were found five months later. A MIBG-1131 scintigraphic image of the adrenals lead to the suspicion of a bilateral pheochromocytoma. The surgical resection of the adrenals confirmed the diagnosis. There was no response to chemotherapy and the patient continued with severe hypercalcemia, repeated infections, persistent diarrhea and cachexia, dying one year after the diagnosis. There was no family history of the disease. We conclude that this is a particularly aggressive presentation of a multiple endocrine neoplasia type 2A.

Adrenal Gland Neoplasms↗

Comparison between factor analysis of dynamic structures and Fourier analysis in detection of segmental wall motion abnormalities: a clinical evaluation.

To evaluate Factor Analysis of Dynamic Structures (FADS) versus or in association with other methods, a protocol was set up including as 'gold standard' investigation the left ventricular angiography (LVA) and processing by Fourier Analysis (FA), and FADS with different variants. To refine the diagnosis of Regional Wall Motion Abnormalities (RWMA), processing was done on a sectorial basis for more accurate spatial localization and functional description. 53 patients were studied (8 normal, 45 with coronary artery disease). FADS gave better results than FA on a sectorial basis. Total agreement between FADS and LVA was obtained in 208/265 (78%), while FA was in agreement with LVA in only 167/265 segments (63%). Globally, FADS was significantly better than FA (Z-test: p < 0.05). When only the diagnosis of maximal abnormality was considered, FA and FADS are statistically equivalent. The superiority of FADS vs FA is more obvious in the diagnosis of hypokinesia. Most FA discrepancies corresponded to underestimation of WMA.

Adult↗

[Gyneco-obstetric aspects in women developing postpartum depression].

The relationship between different variables was studied related to pregnancy, labor, puerperium, newborn and breast-feeding with the development of a depressive disorders during pregnancy, in a sample of 125 pregnant women. No relationship it's found with the presence of disease during the gestation period, except urinary tract infection. The same happens with other variable of labor, puerperium and newborn, Nevertheless, the major stress situations (urgent cesarean section, use of anesthesia during labor, diseases of the newborn, etc.) systematically present a higher incidence of depression. It is observer a relationship between the development of a depressive disorders and a decrease of the natural lactation period.

Adolescent↗

[Blood pool in the study of hepatic hemangioma].

Blood pool scintigraphy is a useful tool in the diagnosis of hepatic hemangioma. We reviewed retrospectively the clinical histories of 24 patients with abnormal blood pool scintigraphies and a presumptive diagnosis of hepatic hemangioma, based on clinical or ultrasonographic findings. In 20 of these patients, blood pool scintigraphy was diagnostic for hepatic hemangioma. The diagnosis was confirmed by an asymptomatic clinical evolution of 12 to 78 months in all the patients, CT scan in 8, angiography in 5 and liver biopsy in one. In the remaining 4 patients scintigraphy ruled out the presence of a hepatic hemangioma. Our results are similar to previous reports in the literature and blood pool scintigraphy has a high specificity for the diagnosis of hepatic hemangioma.

Adolescent↗

[Depressive disorders during pregnancy and associated factors].

A group of 125 pregnant women is studied that is under the control of 2 urban and 1 rural health clinic, were it was found an incidence of 29% of depressive disorders. It is observed that three aspects are strongly related with this disorders: unwanted pregnancy, unsatisfactory couple relationships and personal back-ground with depression. A working model is proposed that seeks to comprehend this phenomenon in its entirety.

Adolescent↗

[Renal scintigraphy with captopril in the evaluation of renovascular hypertension].

The administration of an angiotensin-converting enzyme (ACE) inhibitor transitorily reduces the GFR in a kidney with renal artery stenosis, effect that can be ascertained with scintigraphic studies using ACE inhibitors. We evaluated the clinical usefulness of captopril renography (CR) in the diagnosis of renovascular hypertension (RVH) in 51 hypertensive patients in which this diagnosis was suspected. All subjects underwent angiography and RVH was diagnosed when renal artery stenosis exceeded 60%, there was lateralization of renal vein renin or there was a concordant clinical outcome. Renography was performed 15 minutes after Lasix administration, using Tc-99m DTPA, before and 60 minutes after the oral administration of 50 mg of captopril. The scintigraphic criteria for a positive test were a decreased split renal function, a delayed peak uptake, a decreased excretion of DTPA and a prolonged transit time. In three of 28 patients in whom angiography discarded RVH, CR was positive. In the 23 patients with confirmed RVH, CR was positive in 10 of 12 with unilateral stenosis, in 3 of 8 with bilateral stenosis and 1 of 3 with stenosis in a transplanted kidney. The overall sensitivity and specificity of the test for RVH was 60.9% and 89.2% respectively. There were no changes in blood pressure or adverse effects after captopril administration. We conclude that CR in RVH is useful to select patients for further studies (angiography) and to perform a functional interpretation of angiographic alterations.

Adolescent↗

Use of radionuclide renal imaging for clinical followup after extracorporeal shock wave lithotripsy of renal stones.

Patients treated by extracorporeal shock wave lithotripsy (ESWL) are usually evaluated by excretory urography within 1 month after treatment to determine the clearance of stone debris and rule out asymptomatic obstruction. In an attempt to obtain more precise functional information, we used 99mtechnetium-diethylenetriaminepentaacetic acid and 131iodine-hippurate radionuclide renal imaging studies, and a plain abdominal radiograph as the initial followup study after ESWL of 64 kidneys in 55 patients. Of 53 kidneys studied within 60 days after ESWL 42 had abnormal radionuclide renal imaging studies demonstrating pelviocaliceal stasis, excretory delay or poor function, 8 of which required subsequent interventions for obstructing stone debris. Five patients had excretory delay after ESWL that was unexpected based on a pre-ESWL excretory urogram showing normal function without dilation. A subset of 23 patients with large stone burden or anatomical deformity from a prior operation had baseline radionuclide renal imaging studies before ESWL; function improved in 4 and worsened in 5 by radionuclide renal imaging studies after completion of treatment. A total of 19 patients had radionuclide renal imaging studies earlier (within 17 days) after ESWL because of poor function and/or large stone burden, and as expected they had evidence of obstruction from stone debris, which necessitated further followup. Our experience suggests that followup of ESWL by radionuclide renal imaging studies provides specific functional information that is of particular value in the management of patients with obstructing stone debris and/or diminished renal function. Radionuclide renal imaging studies may also reveal unsuspected obstruction or functional impairment after ESWL of uncomplicated stones, and is recommended as routine followup after ESWL.

Follow-Up Studies↗

[Diagnosis of activity in Crohn's disease and ulcerative colitis: scintigraphy with TC-99m glucoheptonate labelled leukocytes].

We evaluated a pre-tinning leukocyte labeling technique using Glucoheptonate-Sn lyophilized kit, in the detection of activity in 15 patients with clinical and laboratory signs of active inflammatory bowel disease (IBD). 25 patients, without gastrointestinal disease were the control group. In 7/8 patients with Crohn's disease and in 7/7 with Ulcerative Colitis the study was positive. The negative study corresponded to a patient who has only involvement of the duodenum, an area of difficult evaluation due to the high liver uptake. 3/25 patients of the control group had activity in the intestine at 4 hour images. In spite of the small group evaluated, we believe that this labeling technique is a promising procedure for evaluation of activity in patients with IBD (Sensitivity 93.3%, Specificity 88.0%).

Adult↗

[Early test of thallium dipyridamole after myocardial infarction: prognostic value and correlation with coronarography].

Fifty three patients were studied with dipyridamole thallium myocardial scintigraphy, 4 to 6 days after a first episode of myocardial infarction. Localization of infarction was anterior in 25 and inferior in 28. Infarction was confirmed by myocardial scintigraphy in 87% of cases. A non q wave myocardial infarction was present in 5 of the 7 patients with negative scintigraphy. Residual myocardial ischemia was suggested by myocardial scintigraphy in 68% of patients. Correlated to coronary arteriography, sensitivity for myocardial ischemia was 80%, specificity 82%. After a mean follow up of 11.2 months, 22 of 36 patients with positive myocardial scintigraphy had new coronary events, 15 of them requiring myocardial revascularization. In contrast, only 2 of 17 patients with negative scintigraphy had new events (p < 0.05). Thus dipyridamole thallium myocardial scintigraphy early after myocardial infarction is a valuable prognostic test.

Adult↗

[Platelet labelling with In-111-oxine: platelet survival and the images].

We studied 10 male and 2 female normal non-smoker volunteers (mean age 25) by labeling of autologous platelets with 111-In oxine. Daily samples for platelet survival were obtained in all, gamma-camera images in 10 and blood pool digital subtraction with 99m-Tc labeled erythrocytes in 6. Mean platelet count was 594 +/- 235 10(3)/mm3; collagen platelet aggregation pre and post labeling was 74 +/- 4.8 and 70 +/- 10%, respectively. Mean labeling efficacy was 65 +/- 15.4%, mean labeling dose was 201 +/- 79.5 microCi. A linearized initial survival of 7.9 +/- 1 day was obtained. Scintigraphic images showed circulating activity, greater in the spleen, persisting after digital subtraction. The method described can be used for clinical evaluation of platelet disorders and thrombosis.

Adult↗