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Biomedical subjects

E Ruiz

Publications and source records attributed to E Ruiz.

At least 19 recordsLinked to original sources
PubMed1992

Internal cardiac massage and mediastinal irrigation in hypothermic cardiac arrest.

Two unconscious patients with unknown past medical histories were found to be severely hypothermic, with core temperatures of 80.2 degrees F and 86.7 degrees F, respectively. During the course of active internal rewarming, both patients sustained a cardiac arrest. Emergency thoracotomies were immediately done, and internal cardiac massage with warmed mediastinal irrigation was performed. Spontaneous cardiac activity developed in both patients. Within 24 hours after resuscitation, both patients were responsive and following commands.

Heart Arrest↗
PubMed1992

Emergency department echocardiography improves outcome in penetrating cardiac injury.

STUDY OBJECTIVES: To determine the effect of immediate two-dimensional echocardiography on the time to diagnosis, survival rate, and neurologic outcome of patients with penetrating cardiac injury. DESIGN: A ten-year retrospective review. SETTING: Regional trauma center serving a population base of 1.25 million with 85,000 visits yearly. TYPE OF PARTICIPANTS: All patients presenting to the emergency department with penetrating cardiac injury. MEASUREMENTS AND MAIN RESULTS: The records of 49 patients with penetrating cardiac injury were reviewed. Of these, 28 received immediate two-dimensional echocardiography in the ED (echo group) and 21 did not (nonecho group). The probability of survival was derived using TRISS methodology. Differences between groups were determined using either the two sample t-test for parametric data or the Mann-Whitney test for nonparametric data. The overall probability of survival was 33.2%, and the actual survival rate was 81.6%. The probability of survival was 34.2% and 31.8% for the echo group and nonecho group, respectively. The actual survival was 100% in the echo group and 57.1% in the nonecho group. The average time to diagnosis and disposition for surgical intervention was 15.5 +/- 11.4 minutes for the echo group and 42.4 +/- 21.7 minutes for the nonecho group (P less than .001). The Glasgow Outcome Score was 5.0 for the echo group and 4.2 for the nonecho group (P = .007). CONCLUSION: Since the introduction of immediate ED two-dimensional echocardiography, the time to diagnosis of penetrating cardiac injury has decreased and both the survival rate and neurologic outcome of survivors has improved.

Adult↗
PubMed1992

[Antimalarial effect of n-hentriacontanol isolated from Cuatresia sp (Solanaceae)].

The antimalarial activity of the fatty alcohol, n-hentriacontanol, isolated from the bolivian Solanaceae, Cuatresia sp, is investigated in vivo through a classical four-day suppressive test against Plasmodium berghei and P. vinckei in mice. This product markedly reduced the virulence of experimentally induced P. vinckei infection. n-Hentriacontanol belongs to a new class of antimalarial natural compounds to be exploited for therapeutic purposes.

Animals↗
PubMed1992

Androgenic status in cyclic and postmenopausal women: a comparison between smokers and nonsmokers.

Serum total testosterone (T), free testosterone (fT) sex hormone binding globulin (SHBG), androstenedione (A) and 3 alpha androstanediol glucuronide (3 alpha-diol G) levels as well as serum free androgen index (FAI), fT/T and 3 alpha-diol G/T ratios were measured in premenopausal and cyclic women, grouped according to sexual status and smoking status. Our results showed that serum T, fT, SHBG, A and 3 alpha-diol G levels were lower in cyclic women in the follicular than in the luteal phase of the ovarian cycle, although the differences between these values were not significant. Postmenopausal women had significantly lower values of T, fT, A 3 alpha-diol G, FAI and 3 alpha diolG/T but not SHBG and fT/T than cyclic women. When we compared women smokers and nonsmokers, women smokers had serum levels of T, fT, SHBG, 3 alpha-diol G, and values of FAI, fT/T and 3 alpha-diol G/T, similar to those in nonsmokers. Serum A levels were higher in women smokers than in nonsmokers, although the difference was significant only in postmenopausal women.

Androgens↗
PubMed1992

Survival after emergency department versus operating room thoracotomy for penetrating cardiac injuries.

The authors undertook a 6-year retrospective review to assess their experience with penetrating cardiac injuries. Special emphasis was placed on identifying patients with and without tamponade and those requiring emergency department (ED) thoracotomy. Forty-eight patients were identified. Overall survival was 64.6 per cent. Thirty-three patients had tamponade, with 20 requiring ED thoracotomy. Fifteen patients did not have tamponade and two of these needed ED thoracotomy. Five patients who had ED thoracotomy were long-term survivors (22.7%). The remaining 26 patients, 13 with tamponade and 13 without, received operating room (OR) thoracotomy and all survived. The data shows that excellent results are possible with OR thoracotomy for penetrating cardiac injuries, with or without tamponade. However, results are not as good when ED thoracotomy is necessary. This may relate to the severity of the injury, the duration of tamponade, or the inability to control cardiac bleeding during thoracotomy in the ED setting. Even though survival is low with ED thoracotomy, it is high enough to continue to support its use in the deteriorating patient with a penetrating cardiac wound.

Adolescent↗
PubMed1991

Correlation of emergency health care use, 911 volume, and jail activity with welfare check distribution.

STUDY OBJECTIVES: The purpose of this study was to examine the relationship among emergency health care use, 911 call volume, and jail admissions with the timing of the distribution of General Assistance, Aid to Families With Dependent Children, and Minnesota Supplemental Aid welfare checks. DESIGN: This was a retrospective study analyzing previously collected census and welfare check distribution data. SETTING: The data used in this study were obtained from the Hennepin County Medical Center, the Hennepin County jail and alcoholic receiving center, and Department of Economic Assistance. INTERVENTIONS: The daily census for the years 1986 through 1988 in the Hennepin County Medical Center emergency department, ED resuscitation room, pediatric ED, crisis intervention center, urgent care center, and alcoholic receiving center was obtained. The numbers of daily ambulance runs, nonelective hospital admissions, Hennepin County 911 calls, and Hennepin County jail admissions for the same years also were obtained. Means for each day of the month were computed across the 36 months of observation. These data were correlated with the number of days elapsed since the monthly issuance of the General Assistance, Aid to Families With Dependent Children, and Minnesota Supplemental Aid welfare checks. MEASUREMENTS AND MAIN RESULTS: There were significant correlations between the number of days after distribution of the checks and the average values of the census of the alcoholic receiving center (r = -.96, P less than .00001), the ED (r = -.80, P less than .0001), ambulance runs (r = -.68, P less than .0001), 911 calls (r = -.45, P = .01), jail admissions (r = -.45, P = .01), nonelective hospital admissions (r = -.44, P = .01), and the crisis intervention center visits (r = -.39, P = .03). CONCLUSIONS: The findings suggest that scheduling and staffing practices of various emergency service areas in Hennepin County reflect patient load variation associated with time of welfare check distribution. Systematic variation of time or amount of welfare could lead to improved distribution and reduction of emergency services demand.

Ambulances↗
PubMed1991

[Continuous ambulatory peritoneal dialysis (CAPD): an alternative for the treatment of children with terminal chronic renal insufficiency in Argentina].

Twenty three children aged 0.4 to 15 years, (x 7.5 years) with end-stage renal disease were treated with continuous ambulatory peritoneal dialysis (CAPD) over 46 months. The mean time of treatment for the group was 13 months (range 1.0 to 31 months). Sixty five percent of the patients had readmission after catheter placement; 53% were for peritonitis. Nine out of 23 patients (39%), presented 20 episodes of peritonitis, an incidence of one episode per 15 patient months. Gram positive organisms were culture in 60% of these episodes. A total of 26 peritoneal catheters were placed in 23 patients. Of the five catheters that required replacement, three were for peritonitis. Seven out of 23 patients had nephrotic syndrome when admitted to CAPD, four of which develop peritonitis. Although no difference was seen between nephrotic and non nephrotic patients in relation to CAPD initiation and peritonitis development, nephrotic patients without peritonitis and non nephrotic had significantly higher initial growth index for height and iron binding capacity than those with nephrotic syndrome and peritonitis (-1.71 +/- 0.90 vs -2.29 +/- 0.27, P less than 0.05, and 265 +/- 50.5 vs 175 +/- 5.0 mg/dL, P less than 0.0005, respectively). No difference in mean plasma gamma globulin concentration was seen between patients with and without peritonitis. In 14 patients followed for a period greater than to 6 months, the delta growth index for weight and height and was: -0.13 +/- 0.31 and -0.31 +/- 0.46, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

Activity of the hypothalamo-pituitary ovarian axis in hypothyroid rats with or without triiodothyronine replacement.

The hypothalamic pituitary ovarian axis in adult female rats with 131-I induced hypothyroidism was studied before and after triiodothyronine (T3) replacement. Forty days after 131-I, hypothyroid (H) rats showed irregular cycles with predominantly diestrous vaginal smears, atrophied and underweight ovaries, and decreased serum T3, T4, LH and estradiol (E2). T3 replacement restored normal cycles and ovary weight and increased serum E2 levels above control values, while LH levels remained below the limit of detection of the RIA. The GnRH stimulation test performed on the day that the rats exhibited diestrous vaginal smears elicited a greater increase in FSH than in LH in H rats and a greater increase in LH than in FSH in both H-T3 treated and control rats. The data suggest that the lack of thyroid hormones in adult female rats seems to produce a reversion of sexual hormones to a prepubertal pattern, while T3 treatment restored normal estrous cycles and ovarian function.

Animals↗
PubMed1990

Fiberoptic intubation in the emergency department.

Fiberoptic-aided endotracheal intubation has been shown to be effective in difficult intubation secondary to anatomic abnormalities and traumatic conditions. A retrospective review of emergency airway management in an emergency department during a 30-month period found 35 patients who underwent fiberoptic-aided endotracheal intubation; 31 were treated for medical conditions, and four were trauma patients. Indications in the medical group included failed nasotracheal intubation (ten), anatomic abnormalities (six), and the initial airway maneuver attempted (15). Indications in the trauma group with suspected cervical-spine injury included failed nasotracheal intubation (one) and initial airway maneuver attempted (three). In the medical subgroup, 25 of 31 patients were intubated successfully fiberoptically. All four trauma patients were intubated successfully, and all attempts were done nasally. The limitations of the technique were varied. Twenty of the 25 successful intubations had times recorded for completion (mean time, 1.8 +/- 1.4 minutes [SD]). Four of the six failed attempts had recorded times of 7.8 +/- 1.4 minutes. The mean time of the four trauma cases was 3 +/- 2.2 minutes. The presence of secretions, blood, or vomitus was the cause in five of the six failed intubations. The sixth patient kept swallowing the distal end of the scope. Fiscal restraints may also limit its use. At our institution, the financial commitment has been approximately +17,000 during the past nine years. Repair or replacement of broken equipment appears to be necessary every two or three years. Immediate airway control is often difficult with fiberoptic-aided endotracheal intubation and should be used only in selected patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Costs and Cost Analysis↗
PubMed1989

An analysis of time delays preceding thrombolysis for acute myocardial infarction.

For a patient to derive maximal benefit from intravenous thrombolytic therapy for acute myocardial infarction, early treatment is essential. As part of the Thrombolysis in Myocardial Infarction II trial, this study investigated the time delays that preceded treatment of 236 consecutive patients with intravenous tissue-plasminogen activator (TPA) during acute myocardial infarction. The average (+/- SD) time from the onset of symptoms to treatment with TPA was 153 +/- 54 minutes. After arrival in the emergency department, patients waited an average of 19.9 +/- 17.8 minutes for the initial electrocardiogram. Following the diagnosis of acute myocardial infarction by electrocardiogram, an additional 70 +/- 40 minutes elapsed before thrombolytic therapy began. The interval between the initial electrocardiogram and initiation of treatment with TPA was less when the drug was first administered in the emergency department (46.8 +/- 23.4 minutes) rather than after transfer to the coronary care unit (82.1 +/- 34.7 minutes). In-hospital delays at the two academic and two private hospitals accounted for more than half of the total time from the onset of symptoms to initiation of thrombolytic therapy. We conclude that significant in-hospital delays are likely to occur before a patient receives thrombolytic therapy for acute myocardial infarction. Various factors conspire to create these delays, but a well-organized team approach to treatment will help to minimize delays in the implementation of this new form of therapy.

Adult↗
PubMed1989

A comparison of open peritoneal lavage with modified closed peritoneal lavage in blunt abdominal trauma.

A randomized prospective study compared open peritoneal lavage using a peritoneal dialysis catheter with modified closed lavage using either the Lazarus-Nelson or Cook lavage catheter. The time required to perform the lavage, technical difficulties, complications, and accuracy were assessed in 63 adult victims of blunt abdominal trauma. The average time to perform lavage was 21.1 minutes for open lavage, 14.7 minutes for Lazarus-Nelson closed lavage, and 9.8 minutes for Cook closed lavage. The closed technique using the Cook catheter was significantly faster than open lavage. Technical difficulties were significantly less frequent with Cook catheter closed lavage than with Lazarus-Nelson catheter closed lavage. The overall complication rate was 1.8%, and the overall accuracy was 98.1%, without apparent difference among techniques. It is concluded that, when no contraindications to closed lavage exist, and when time is of importance, closed lavage with the Cook catheter is the preferred technique.

Abdominal Injuries↗
PubMed1989

Comparison of single-dose meperidine, butorphanol, and dihydroergotamine in the treatment of vascular headache.

We treated 64 emergency room patients with a primary vascular headache with dihydroergotamine (DHE), meperidine, or butorphanol. Post-treatment pain scores were lowest in the DHE group (p less than 0.01). Eight of 21 patients receiving DHE had greater than 90% reduction in pain compared with three of 19 patients receiving butorphanol and none of 22 receiving meperidine.

Adult↗
PubMed1989

Incidence and diagnosis of C7-T1 fractures and subluxations in multiple-trauma patients: evaluation of the advanced trauma life support guidelines.

A 5-year retrospective review was done to evaluate C-7 and C7-T1 cervical spine injuries and to assess the advanced trauma life support guidelines for cervical spine evaluation. Eighteen fractures of C-7 and four fracture-dislocation at C7-T1 were identified. Nineteen of the patients had neck pain, tenderness, or neurologic findings on initial examination. Three patients were awake and asymptomatic. The initial diagnosis could be made from lateral cervical spine x-ray film in only three of the 22 patients. In the remaining patients, the diagnosis was made by either swimmer's view (7 of 8 positive), oblique views (1 of 1 positive), flexion-extension views (2 of 3 positive), or computed tomography (CT) scan (7 of 7 positive). In two patients, the diagnosis was not made in the first 24 hours. Follow-up x-ray films were positive in 3 of 22 lateral cervical spine films, 10 of 14 swimmer's views, 2 of 3 oblique views, 2 of 3 flexion-extension views, and 14 of 20 CT scans. The data support the advanced trauma life support recommendation for liberal use of cervical spine radiologic screening. We recommend that the screening examination consist of a lateral cervical spine film, and a swimmer's view, if necessary, to visualize C-7 and the C7-T1 interspace. We further recommend that strong consideration be given to the use of a five-view trauma series. CT scan should be viewed as complementary to conventional film techniques.

Adolescent↗
PubMed1988

Influence of intracerebroventricular (ICV) injection of ACTH (1-24) on plasma gonadotropin in female rats: dose-response study.

The intracerebroventricular (ICV) injection of ACTH (1-24) (0.1, 1.0 and 2.5 micrograms) to adult conscious ovariectomized (OVX) rats caused a dose-related inhibition of plasma LH at 10 min postinjection. The ICV injection of ACTH (1-24) (2.5 micrograms) to OVX rats in the absence or presence of a single dose of estradiol benzoate (OVX + EB): a) Decreased significantly plasma LH levels in OVX rats at 10 and 30 min postinjection. b) Decreased significantly plasma LH levels in (OVX + EB) rats at 10 min but not at 30 min postinjection. c) Did not change plasma FSH levels at 10 or 30 min postinjection in both (OVX) or (OVX + EB) rats. d) Did not change plasma ACTH levels at 10 or 30 min postinjection in (OVX) rats. Our observation suggest that ACTH (1-24) inhibited plasma LH, possibly through brain sites of action.

Adrenocorticotropic Hormone↗
PubMed1988

Balance of production and consumption of ATP in ammonium-starved Saccharomyces cerevisiae.

To establish a balance between the ATP produced in catabolism and the ATP consumed in net biosynthesis of cellular components the energy metabolism of Saccharomyces cerevisiae utilizing glucose in the absence of a nitrogen source (resting cells) was studied. The following results were obtained. (i) Cell number and biomass increased 2- and 2.5-fold, respectively, during the first 8 h of ammonium starvation. After this period, both values remained constant. (ii) The rate of sugar consumption and ATP production decreased with the duration of starvation to about 20% of the original in 24 h. (iii) About 60% of the sugar consumed was fermented to ethanol and about 10% assimilated as cellular material. Of the assimilated sugar, as much as 80% was accumulated as carbohydrate. (iv) Only 15% of the total ATP produced in catabolism seems to be consumed in net biosynthesis and maintenance of intracellular pH. The fate of the remaining 85% is unknown.

Adenosine Triphosphate↗
PubMed1988

[Effects of age and obesity on the conversion of androstenedione to estrone in postmenopausal women].

The effects of aging as well as body weight on conversion of circulating Androstendione (A) to Estrone (E1) in 21 postmenopausal women of different ages and body weights have been studied. Serum concentration of A and E1 were measured by RIA. The E1/A ratio was correlated with total body weight, body mass index, excessive body weight, age and years after cessation of menstruation. The results show that the E1/A ratio was significantly correlated with total body weight, body mass index and excessive body weight. In contrast the E1/A ratio is not significantly correlated with age or years after cessation of menstruation.

Aging↗