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Biomedical subjects

F Fernandez

Publications and source records attributed to F Fernandez.

At least 91 records · Page 5Linked to original sources
PubMed1991

Psychopharmacotherapy of psychiatric syndromes in asymptomatic and symptomatic HIV infection.

It is evident that human immunodeficiency virus (HIV) infection is one of the most serious public health issues in decades. HIV infection compromises cell-mediated immunity which ultimately may result in the acquired immunodeficiency syndrome (AIDS). AIDS, to date, remains an incurable and progressively fatal disorder. HIV infection is spreading beyond the originally identified high-prevalence groups of gay/bisexual males, intravenous drug abusers, and recipients of infected blood or blood products. Today, more and more heterosexual males, women, adolescents, and children have been infected with this lethal virus. This report addresses some of the psychiatric complications associated with HIV infection and discusses the diagnostic and clinical management challenges that clinicians must face as they deal with the increasing population of HIV-infected patients. Depression, anxiety, psychosis, delirium, and dementia are commonly encountered disorders associated with HIV spectrum disorders which must be accurately identified and can be effectively managed with psychopharmacological interventions.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Fasted state impedes recovery of porcine hepatic oxygen consumption after warm hepatic ischemia.

The most effective means to prepare the hepatic donor liver for harvest, preservation, and transplantation are not known. Studies have shown that in combination with an injury to the liver, fasting reduces hepatic function. This study randomized 20 market pigs, 20 to 45 kg, to an overnight fast (fed group) or a 42-hour fast (fasted group). Under general anesthetic perfusion of the portal vein and hepatic artery were controlled. Studies were performed at high flow (30 ml/min/kg portal flow and 10 ml/min/kg arterial flow) and after a 90-minute period of warm ischemia (no flow). Flow was restored at 25% of the original (low flow), then increased to 50% of the original (medium flow). After the ischemic insult, the fed group improved hepatic oxygen consumption at a faster rate than the fasted group (p less than 0.05 by ANOVA). In addition, significant differences were noted between the fed and fasted groups in the amount of insulin delivered by the portal venous system to the liver (p less than 0.001 by ANOVA). Hepatic oxygen consumption was related to insulin delivery (r2 = 0.46; p less than 0.001) for both groups. The data suggest that acute changes in the nutritional status of both the donor and the recipient may affect hepatic recovery from ischemia.

Amino Acids↗
PubMed1990

Preliminary report: follow-up after dynamic cardiomyoplasty.

Five patients were studied 5-13 months after dynamic cardiomyoplasty for refractory heart failure. In two, muscle flap stimulation caused a pronounced increase in cardiac index (mean 55%) and ejection fraction (mean 75%); no patient showed improvement in cardiac filling pressure. 2 years after surgery, one of the patients with haemodynamic improvement died from ventricular fibrillation, and histochemistry of the stimulated muscle flap revealed predominantly fatigue-resistant type I fibres, without evidence of fibrosis. In selected cases, dynamic cardiomyopathy could be of long-term benefit.

Adult↗
PubMed1990

The many faces of AIDS: opportunities for intervention.

Social and cultural issues may have a profound impact on different populations' responses to the AIDS epidemic. To maximize their own effectiveness, clinicians need to be aware of special needs and concerns.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Dietary modification of potential vitamin K supply from enteric bacterial menaquinones in rats.

Rats given a low-fibre diet based on boiled white rice developed symptoms of severe vitamin K deficiency within 23 d. Inclusion of autoclaved black-eye beans (Vigna unguiculata) in the diet prevented the bleeding syndrome. To test the hypothesis that deficiency resulted from low phylloquinone intake exacerbated by inadequate production of menaquinones by the enteric bacteria, a follow-up experiment was carried out in which groups of rats were given an all-rice diet, a rice + beans diet or a stock diet. Rats on the all-rice diet had significantly lower faecal concentrations of the main menaquinone-producing bacterial species (Bacteroides fragilis and Bacteroides vulgatus) than animals on either of the other two diets. This coupled with the much lower faecal output on this diet suggests that total menaquinone production was low for the all-rice diet. The alterations in faecal flora were associated with several significant changes in caecal metabolism. Rats given the stock diet had much shorter caecal transit times and a considerably greater proportion of butyric acid in volatile fatty acid end-products than did rats on either of the other two diets.

Animals↗
PubMed1990

Tolerance and efficacy of parenterally administered penicillin-streptomycin and orally administered amoxicillin or penicillin V for prophylaxis of experimentally induced streptococcal endocarditis.

A regimen of a single intramuscular dose of penicillin G-streptomycin was compared with regimens of three oral doses of amoxicillin and two oral doses of penicillin V to prevent Streptococcus sanguis endocarditis in rabbits with experimentally induced valvular heart lesions. Challenge doses of 10(4), 10(6), and 10(8) CFU of a strain of S. sanguis highly tolerant to penicillin and amoxicillin were used. The combination of penicillin and streptomycin was the only regimen tested that provided full protection even against the highest inoculum concentration. A single oral dose of penicillin V (36 mg/kg) or amoxicillin (50 mg/kg), two oral doses of penicillin V (36 and 18 mg/kg with a 7-h interval between doses), or six oral doses of amoxicillin (50 mg/kg followed by 8.5 mg/kg at 8-h intervals) protected recipients of the lowest inoculum concentration; protection diminished with increasing inocula. In contrast, administration of two high oral doses of amoxicillin (50 mg/kg) with a 10-h interval between doses provided full protection against challenge doses of 10(4) and 10(6) CFU, preventing endocarditis in 10 (66%) of 15 recipients of 10(8) CFU. All regimens evaluated were highly effective in preventing endocarditis when rabbits were challenged with 10(4) CFU. The combination of penicillin and streptomycin was the best regimen tested. Administration of two high oral doses of amoxicillin (50 mg/kg) with a 10-h interval between doses led to significantly fewer infections when compared with the other oral regimens when rabbits were challenged with 10(6) and 10(8) CFU.

Amoxicillin↗
PubMed1990

[Progression from hypertrophic obstructive cardiomyopathy to dilated cardiomyopathy. Apropos of 4 cases].

Four cases of hypertrophic obstructive cardiomyopathy diagnosed on clinical, phonomechanographic, echocardiographic and haemodynamic criteria progressing to dilated cardiomyopathy are reported. This evolution was observed over a number of years (up to 20 years) and was accompanied by a clinical aggravation in all cases with 2 deaths and atrial fibrillation in 3 of the 4 cases. The signs of intraventricular obstruction [systolic murmur, bulge on the carotid pulse tracing, systolic anterior motion of the mitral valve (SAM) and intraventricular pressure gradient] disappeared as the left heart chambers dilated with a reduction in ventricular wall motion and parietal thinning but no change in myocardial mass.

Adult↗
PubMed1990

[Dynamic cardiomyoplasty. Hemodynamic study of 3 patients].

Dynamic cardiomyoplasty is a surgical operation aimed at compensating for a loss of substance or a severe deficiency of the left ventricular myocardium by implanting around the heart the latissimus dorsi muscle the contraction of which, synchronous with that of the ventricles, acts on the heart in the manner of a massage or milking. The operation, which in its present form is recent, consists of applying Onto the heart, or wrapping that organ with, a skeletal muscle that keeps its neurovascular supply and its high insertion, and of installing the appropriate electrodes and a pacemaker. We report the haemodynamic data collected in 3 patients operated upon for severe cardiac failure 13, 8 and 9 months ago respectively and who are now in NYHA functional stages I and II. During 1/1 stimulation of the latissimus dorsi systolic pressures remain unchanged while diastolic pressures rise; cardiac output increases satisfactorily in two of the patients (cases No. 1 and 3) and is unmodified in the third one (case No. 2). We conclude that cardiomyoplasty seems to give favourable results but its future and indications remain to be determined.

Adult↗
PubMed1989

Pouchitis.

Explore the source record for details and available documents.

Anal Canal↗
PubMed1989

Psychiatric aspects of HIV disease.

Psychiatric disorders associated with human immunodeficiency virus (HIV) infection are increasingly prevalent. The psychologic, sociocultural, and medicolegal dimensions of HIV disease further fragment and complicate the care of these individuals. This article reviews the psychiatric aspects of HIV disease and suggests practical approaches to management and patient care.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Consultation-liaison psychiatry and HIV-related disorders.

Acquired immune deficiency syndrome (AIDS) and related disorders are increasingly and unsettlingly prevalent. The authors describe neuropsychiatric, psychosocial, and ethical-legal problems associated with HIV infections that are commonly encountered in a consultation-liaison psychiatry setting. Because of HIV's potential for undermining cognitive function, they recommend a systematic neurobehavioral assessment for the differential diagnosis of emotional disturbance, including a test battery that also identifies neurotoxic effects of pharmacological agents. Among significant psychosocial and ethical-legal problems are patient's reactions to AIDS, their fears of social abandonment, staff burn-out, antibody testing, confidentiality, and the use of life-support measures. The consultation-liaison psychiatrist's awareness of the complexities of HIV-related neuropsychiatric symptoms and psychosocial issues can be of enormous benefit to medical caregivers and to the patients themselves.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Beta-2-microglobulin in the assessment of renal function in full term newborns following perinatal asphyxia.

In order to evaluate the clinical usefulness of serum and urinary beta 2 microglobulin (beta 2-m) determination as a marker of renal damage following perinatal asphyxia, twenty asphyxiated and twenty healthy full term newborns were studied. Renal function was monitored on the first and third day after birth by traditional tests such as creatinine (Cr), endogenous creatinine clearance (Ccr), and fractional Na excretion (FeNa), as well as by serum and urinary beta 2 microglobulin. The value of different tests for the diagnosis of oliguria and of acute renal failure was determined. Eleven asphyxiated neonates developed oliguria and five ARF in contrast to none of the controls. Both traditional tests of renal function, and determinations of beta 2-m with the exception of serum beta 2-m, were significantly different (p less than 0.01) between controls and asphyxiated neonates. When stratified analysis was performed, only serum cr, urinary beta 2-m/cr ratio, and Fe beta 2-m were able to discriminate oliguria from preserved diuresis on the first day of life. For ARF, only Ccr and Fe beta 2-m were different, again on the first day of life. Urinary beta 2-m/creatinine ratio and Fe beta 2-m appear to be more sensitive and specific for the early detection of proximal tubular renal dysfunction following perinatal asphyxia than usual tests of renal function.

Asphyxia Neonatorum↗
PubMed1989

Management of delirium in terminally ill AIDS patients.

Delirium is the most common neuropsychiatric complication of hospitalized AIDS patients. Typically, delirium is multifactorial in etiology and a complete evaluation to rule out all treatable, contributable medical conditions should be the first stage in the approach to a delirious AIDS patient. While a search for probable cause is underway, the next goal of treatment should be sedation. To help clinicians recognize and manage delirium in advanced HIV disease, we describe our experience with 206 AIDS patients.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Surgical mitral valvuloplasty and dynamic left ventricular obstruction syndrome].

The "dynamic" left ventricular outflow obstruction syndrome, which is found in 4.5 to 11 p. 100 of patients who underwent mitral valve repair by Carpentier's technique, seems to be due to the association of two different sets of circumstances. The first set is anatomical; the syndrome is thought to result from the implantation of a semi-rigid valve ring, from the excessive length of the mitral valve system in relation to the size of the ventricular cavity, and from excessive correction of mitral regurgitation with subsequent excessive reduction in caliber of the left ventricular outflow tract, change in the interrelation between outflow tract and ventricular filling and strongly anterior position of the mitral valve. The second set is functional; it is due to a more than 20 p. 100 reduction in caliber of the left ventricular outflow tract on the one hand, and to a more than 2.5 m/s increase in blood flow velocity on the other hand. These two phenomena may be produced by a decrease in left ventricular volume as a result of hypovolaemia, tachycardia or more rapid circulation. Treatment of the syndrome consists of correcting the associated abnormalities by prescribing a diet with a normal sodium content, together with an appropriate anti-arrhythmic agent and a beta-blocker.

Adult↗