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Biomedical subjects

F Muñoz

Publications and source records attributed to F Muñoz.

At least 73 records · Page 4Linked to original sources
PubMed1994

Diagnostic utility of color Doppler ultrasound in lower limb deep vein thrombosis in patients with clinical suspicion of pulmonary thromboembolism.

The diagnosis of pulmonary thromboembolism is frequently based on ventilation-perfusion scintigraphy and ascending lower limb venography when pulmonary angiography is not available. The aim of this study is to compare color Doppler ultrasound against ascending venography in the evaluation of the lower limb deep vein system in patients with clinical suspicion of pulmonary embolism, with special attention to calf veins. We prospectively studied 30 patients with clinical suspicion of pulmonary embolism in whom a color Doppler ultrasound and venogram were performed with no more than a 3-h interval between both procedures. The diagnostic criteria was that of loss of venous compressibility. The 'color' ability was used to identify artery from vein. Out of 15 patients in whom a venogram proved positive (50%), 9 had isolated calf vein thrombosis (60%). In 5 patients, the color Doppler ultrasound of the calf was considered inconclusive. Overall sensitivity was 53%, specificity 100%, positive predictive value 100%, and negative predictive value 68%. In the femoropopliteal system, sensitivity was 83% and specificity 100%. Considering all patients, sensitivity in the calf system was 40%. Excluding the 5 patients who were difficult to assess, sensitivity increased to 60%. In conclusion, color Doppler ultrasound is not as sensitive as venography in dealing with patients with clinical suspicion of pulmonary embolism, due to its low sensitivity in the calf system when distal thrombi need to be excluded. However, a reasonable alternative is to begin by performing a compression ultrasonography of the femoropopliteal system. Color Doppler ultrasonography of the calf system represents a rarely sensitive and arduous task and does not seem justifiable in this type of patient.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[An evaluation of the blood culture in disseminated mycobacteriosis].

The objective of this study was to evaluate the usefulness of blood culture in the diagnosis of disseminated mycobacteria (DMB). This prospective study included all blood cultures done for patients with fever and under suspicion of having DMB between January 1991 and July 1992. Fifty-seven blood samples from 16 patients were cultured; 14 (87.5%) patients were HIV positive and all were diagnosed as having DMB. The cultures were processed by lysis-centrifugation and identification of mycobacteria was by hybridization with a DNA probe. Mycobacterial growth was detected in 5 cultures (8.7%) from 4 patients (25%) (3 HIV positive). M. tuberculosis was isolated in 3 and M. avium in 1. Mean time until isolation was 46 days. In all cases mycobacteria were isolated in other samples before they were found in cultures: M. tuberculosis was isolated in 2 bronchial aspirates (BAS), 2 in liver tissue (L), 2 in spleen tissue (S), one in alveolar bronchial lavage, one in sputum, one in spinal fluid (SF) and one in urine. M. avium was isolated in sputum and ALB. The three patients in whom M. tuberculosis was found died 1.4 and 32 days after admission. In samples from the 12 DMB patients with negative cultures (11 HIV positive, 92%), M. tuberculosis was isolated in 100% of ganglion and S samples, 90% in urine, 69% in sputum, 67% in ABL and LB, 63% in BAS and 33% in SF. None of these patients died in hospital. We find blood culture to be of little use in the diagnosis of DMB. Analysis of other samples leads to faster diagnosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Bacteremia↗
PubMed1994

Photophysical study of the Schiff bases of 5'-deoxypyridoxal and n-hexylamine in cationic micelles.

The absorption and fluorescence spectra of the Schiff bases formed between 5'-deoxypyridoxal and n-hexylamine in aqueous media containing different concentrations of the cationic surfactant hexadecyltrimethylammonium bromide were recorded at 25 degrees C. The quantum yields of fluorescence of the different zwitterionic and enol forms of the chemical species of the Schiff bases occurring in media of pH 4.5-8.5 were determined. Also, the fluorescence quenching resulting from the presence of the surfactant and that of iodide ion were analyzed. From the results obtained it follows that the zwitterionic forms do not interact with the cationic surfactant, whereas the enol forms do interact with it.

Amines↗
PubMed1994

[Disasters. Assistance plans].

A disaster is defined as a unseasonable event that provoke such an amount of victims that the health care capacity of the community is exceeded. The aim of this paper is to review the health attention during an emergency period, whose pre-hospital and hospital services are inherent to critical care medicine. The reduction in victim's morbidity and mortality depends on the opportuneness and efficacy of pre-hospital care. Trained personnel is required to establish command posts, perform the rescue, categorize seriousness of victims to receive priority health care and transport to better equipped health centers. At the hospitals an emergency team must elaborate, publish and periodically review emergency care plans and eventually coordinate actions with other community organizations. The diverse phases of the plan must be specified, including preparatives, alerting of involved services, victim care, and reestablishment of normal duties when the emergency situation ceases. As complement, the hospital must have security and evacuation plans to face own emergency situations such as fires, explosions and inundations.

Disaster Planning↗
PubMed1994

[Phenytoin hypersensitivity syndrome].

Diphenylhydantoine is a drug frequently used in the treatment of epilepsia. In rare occasions, it produces a mulsisystemic manifestation characterized by fever, lymphadenopathy, hepatitis, eosinophilia and desquamative cutaneous eruption, which typically develops within 4-8 weeks after the beginning of the treatment. Mortality rates may reach up to 40% in patients with severe hepatic affection, although the response to steroid therapy is usually frequent. We present the case of a patient which developed a syndrome of hypersensibility to diphenylhydantoine with mononucleosic manifestations, icteric hepatitis and exfoliative dermatitis, who completely recovered a few days after his hospitalization.

Adolescent↗
PubMed1993

Quantitative description of the absorption spectra of the coenzyme in glycogen phosphorylases based on log-normal distribution curves.

The absorption spectra of the coenzyme [pyridoxal 5'-phosphate (PLP)] in glycogen phosphorylase a (GPha), glycogen phosphorylase b (GPhb) and of the latter bound to various effectors and substrates were analysed on the basis of log-normal distribution curves. The results obtained showed that the ionization state of the PLP and GPha environment differs from that of GPhb. This divergence was interpreted in terms of tautomeric equilibria between some forms of the Schiff base of PLP and enzymic Lys-679. The ionic forms are slightly more predominant in GPha than they are in GPhb, so ionic and/or hydrogen-bonding interactions between the aromatic ring of PLP and GPha must be stronger than with GPhb. This confirms the purely structural role of the aromatic ring of the coenzyme. Binding of GPhb to AMP and Mg2+ results in the coenzyme adopting a similar state as in GPha. On the other hand, binding to IMP gives rise to no detectable changes in the tautomeric equilibrium of the coenzyme.

Animals↗
PubMed1993

Stimulation by the antioxidant thioproline of the lymphocyte functions of old mice.

Diet supplementation with thioproline (thiazolidine-4-carboxylic acid), an intracellular sulfhydryl antioxidant and free radical scavenger, may slow the aging process of metazoans and prolongs their life span. In the present experiment Swiss mice fed thioproline (0.07%, w/w) from 13 to 22 months of age were used. Six- and 22-month-old mice fed standard diet were used as controls. Two important functions of lymphocytes, the proliferative response to the mitogen Concanavalin A (Con A) and the mobility, both spontaneous and directed to a chemoattractant gradient (chemotaxis), were analyzed in lymphocytes from axillary nodes, spleen and thymus. Mobility and chemotaxis were studied by Boyden's technique, using filters of 3 microns pore diameter, 3 h of incubation and fmet-leu-phe at 10(-8) M as chemoattractant. The proliferative response was estimated as 3H-thymidine incorporation in lymphocytes incubated for 72 h in the presence of Con A (1 and 5 micrograms/ml). The results show a decrease in mobility, chemotaxis and lymphoproliferative response in old mice in comparison to adults. However, a significant increase in these functions was observed in old mice fed thioproline. The advantage of using this antioxidant for immunostimulation during aging, a stage of life characterized by a decreased immune response, is discussed.

Aging↗
PubMed1993

Empyema of the thorax in adults. Etiology, microbiologic findings, and management.

The etiology, microbiologic findings, and management of 82 episodes of empyema treated by our unit over a period of 6 years were analyzed. Average patient age was 54 years. Eighty-two percent had underlying disease such as alcoholism (29 percent), malignancy (23 percent), and diabetes mellitus (20 percent). Sixty (73 percent) had an empyema develop secondary to a bronchopulmonary infection. Other etiologies were as follows: infradiaphragmatic sepsis, five cases; iatrogenic, ten cases; and idiopathic, seven cases. Cultures were positive in 76 cases and negative in the remaining 6 (2 positive Gram stains, 1 positive under bacilloscopy, and 3 were sterile). Anaerobes were isolated from 25 and aerobes from 47 of the positive cultures. A single bacteria was isolated from 43 and multiple organisms (average: 2.63/case) grew on the remaining 33 positive cultures. Length of hospitalization averaged 37 days. Seven patients received antibiotics only, thoracentesis was performed on three, intercostal chest tube drainage was required in 72, and more aggressive surgery was performed on 12 patients (7 with fibrothorax and 5 with pneumonectomy). Streptokinase was instilled into the pleural space of eight patients with good results. Pleural drainage superinfection occurred at a rate of 8.5 percent. Nine patients died; the remaining recovered. Only three deaths came about as a direct result of the empyema.

Adult↗
PubMed1992

[Periodic health examination].

A literature search has been made on the examinations to be performed during the "periodic health exam" on the healthy adult. These examinations shall be performed bearing in mind the prevalence and morbility data of the specific diseases, individual risk factors and the quality (sensibility and specificity) of the diagnostic procedure. The value of regular blood pressure determination, breast exam and cervical cytology with Papanicolaou stain, is well established. However, there is no consensus regarding other determinations, due to the fact that different authors use different approaches. The skin, mouth and thyroid examination for cancer screening is limited only to individuals having risk factors. Heart auscultation for the diagnosis of valvulopathies that could required antibiotic prophylaxis for bacterial endocarditis is important. In individuals over sixty years old, vision acuity and hearing capabilities should be explored, also abdomen should be explored to detect aortic aneurysms. Hypercholesterolemia should be determined in individuals over 20 years old, and PPD should be performed before 35 years old. Concerning the rest of explorations (rectal taction, testicular exploration, etc.) its efficacy has not been clearly established in the screening.

Physical Examination↗
PubMed1991

Spectroscopic study of the Schiff bases of dodecylamine with pyridoxal 5'-phosphate and 5'-deoxypyridoxal. A model for the Schiff bases of pyridoxal 5'-phosphate in biological systems.

We recorded the absorption spectra of the Schiff bases of pyridoxal 5'-phosphate (PLP) and 5'-deoxypyridoxal (DPL) with dodecylamine (DOD) at different pH values. By applying deconvolution techniques to the spectra and analysing their different components we found that the above-mentioned Schiff bases in aqueous solutions of pH 7 adopted a conformation in which the pyridine ring is embedded in a very hydrophobic medium from which water is virtually completely excluded. This conformation in the same as that adopted by PLP when it acts as coenzyme for some enzymes such as glycogen phosphorylase. The experimental results obtained also show such a conformation to be highly favoured but sensitive to the protonation of the pyridine nitrogen, which makes the aromatic ring more readily accessible to the solvent.

Amines↗
PubMed1991

Chronic dissection of the anterior tibial artery leading to acute aneurysmal dilatation.

We present a clinical case of chronic dissection of the anterior tibial artery leading to acute aneurysmal dilatation. Our patient, a 22-year-old man, had a history of trauma at the middle third of his left leg. Because of impending ischemia, he was diagnosed by emergency arteriography. We ligated the proximal and distal ends of the dissection and used a reversed saphenous vein for a short end-to-end bypass. Although the evolution of this dilatation had been silent, its clinical presentation was spectacular. The case is worthy of attention because of its extreme rarity, both as a dissection of a peripheral artery caused by trauma and as an aneurysmal dilatation at tibial level.

Journal Article↗