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F Nieto

Publications and source records attributed to F Nieto.

15 recordsLinked to original sources
PubMed1994

[The "arrhythmic pattern": a new method with prognostic significance in myocardial infarct].

OBJECTIVES: To establish a score or arrhythmic pattern for the prediction of long-term cardiac deaths on patients who have survived to the first acute myocardial infarction. PATIENTS AND METHODS: We studied prospectively 200 patients that survived at a first myocardial infarction and in whom ambulatory ECG monitoring during 24 hours between days 7th and 18th (mean 12th) from the infarction was performed. The mean follow-up time was 51 +/- 18 months. The number and type of ventricular arrhythmias were analyzed and a score was measured, accordingly with Castellanos and Lown's classifications. An "arrhythmic pattern" or "total punctuation" was defined and compared among two groups: group 1 > 65 points and group 2 < 65 points. RESULTS: The differential characteristics of both groups were: age (60 +/- 9 versus 56 +/- 10 years old; p = 0.004); hypertension (63% versus 29%; p < 0.001); clinic stage II-III (23% versus 11%; p = 0.02); echocardiographic ejection fraction (45 +/- 11% versus 50 +/- 10%; p = 0.04); positive exercise testing (73% versus 56%; p = 0.01); arrhythmias on the exercise test (15% versus 25%; p = 0.006). The long-term cardiac mortality was 25% versus 6% (p = 0.01), with an incidence of sudden death of 11% versus 3% (p < 0.05). Specificity, sensibility, positive predictive value and negative predictive value (reference cut point of 100) were 94, 65, 71 and 91%, respectively. CONCLUSIONS: The use of a score of arrhythmic pattern may identify 2 groups of patients with different clinic profiles that probably justify a different long-term prognosis after a first acute myocardial infarction.

Cardiac Complexes, Premature↗
PubMed1991

Cesarean section and maternal age in low-risk nulliparas.

The relationship between maternal age and cesarean section in low-risk nulliparas was analysed in 7454 perinatal clinical records selected from eleven databases of Latin American institutions obtained with a comprehensive perinatal information system. The risk of cesarean section in nulliparas between 29 and 49 years of age was found to be three times higher than that corresponding to pregnant women of lesser age. This clearly more aggressive obstetrical conduct could not be explained by the main indications for cesarean section.

Adolescent↗
PubMed1991

Oxygen transport in newborns at different gestational ages.

Oxygen (O2) transport was assessed through the affinity between O2 and hemoglobin (Hb) in 123 newborns of 28 to 40 week gestational ge, with a minimum of 9 newborns for each gestational age group (see table). In order to assess the O2-Hb affinity, we studied the correlation between the pO2 and the Hb saturation for each gestational age, obtaining estimates of the oxy-hemoglobin dissociation curves corresponding to each gestational age (see fig. 3). The pO2 levels corresponding to the 50% saturation (P50) for each gestational age were estimated from there. All newborns were from single vaginal deliveries with no fetal distress before birth and with an adequate weight for gestational age. The latter was calculated according to the date of the last menstrual period (78% of the cases), echography (10.6% of the cases) or neonatal physical exam (11.4% of the cases). A P50 vs. gestational age linear regression showed a high determination rate (r2 = 0.957, p less than 0.00001) (see fig. 2) which supports the hypothesis of the P50 linear growth; decrease in the Hb-O2 affinity with increasive gestational age (Hb-O2 affinity is different in newborns of different gestational ages). With these results one may conclude that the Hb-O2 uptake varies according to gestational age (P50 changes linearly as gestational age increases) and that a single measurement of pO2 in a newborns, blood does not accurately evaluate the amount of O2 that is transported to the tissues, because the transport capacity depends, among other factors, upon gestational age. The Hb saturation better represents the amount of O2 that can get to the cell level.(ABSTRACT TRUNCATED AT 250 WORDS)

Carbon Dioxide↗
PubMed1989

[Asymptomatic common truncus arteriosus in a 25-year-old patient with paroxysmal tachycardia and truncal valve insufficiency].

We present an adult patient (25-years old), free of symptoms with a congenital heart disease very infrequent and survival to adulthood is exceptional, the truncus arteriosus. Who entered to the Emergency Care Unit because of paroxysmal tachycardia. We describe the case with special reference to echocardiographic findings and we detached the rarity of this congenital heart disease in adulthood.

Adult↗
PubMed1988

Assessment of pulmonary dynamics in normal newborns: a pneumotachographic method.

A pneumotachographic method for assessment of pulmonary dynamics in critically ill newborns in an intensive care setting was developed in our laboratory. Before the results obtained with this method could be applied, the normal range of values were determined in 48 normal term and preterm newborns. Their body weight ranged between 1200 and 4100 g, and postnatal ages between 24 hours and 21 days. In three infants, two determinations were performed after an interval of 7 days. The studies were performed with a pneumotachograph applied to the upper airway by means of an inflatable face mask or latex nasal prongs. The air flow signal was electronically integrated to time to produce a volume signal. Airway pressure was determined proximal to the pneumotachograph. Esophageal pressure was determined with a water filled catheter placed in the lower third of the esophague. Tidal volume (VT), minute ventilation (V), Dynamic compliance (Cdyn), total pulmonary resistance (R), total pulmonary work (Wt), Elastic work (We), and flow resistive work (Wv), were determined. A significant linear correlation was found between Cdyn and body weight (r = 0.50, p less than 0.01) whereas no significative correlation was found between body weight and VT, V or R. Values for VT, V and Cdyn were corrected for body weight and means (X), standard deviation (SD) so as 10th and 90th percentiles are shown in table III. X, SD and percentiles for R were shown in table III. Wt, We and Wv were corrected for V, and X, SD and percentiles shown in table III. Values of VT/Kg, Cdyn/Kg and R are similar to those found by other authors with pneumotachography and plethysmography. The V/Kg values obtained by us were higher than those reported by other authors, which together with the lack of correlation of VT and V with body weight, question the reliability of V values in our study. This could be explained by: 1) excessive increase in dead space in cases in which a face mask was used; 2) nocioceptive stimulus produced by face mask or nasal prongs; 3) inadequate selection of the moment at which the record was obtained. Whichever the explanation, our values of V cannot be considered as basal, and should be interpreted with caution. The results obtained allow us to continue with our program and apply this method to the study of newborn infants with RDS.

Airway Resistance↗
PubMed1985

[In vivo evaluation of the effect of antacids and H2 receptor blockaders on the intragastric pH in gastric and duodenal ulcer].

The aim of this work is to establish the best treatment for patients with gastric and duodenal ulcer, by measuring the effects of antiacids and H2-receptor antagonists on gastric pH. 16 patients were studied: 9 of them had a duodenal ulcer, 2 a gastric ulcer and 5 had both. All the patients remained fasting and receiving no drug for 24 hrs. During this 24 hrs., a nasogastric tube was inserted into the stomach and the gastric content was obtained by aspiration each hour from 8 A.M. to 8 P.M. Three days after, each patient received a daily dose of 1 g of Cimetidine, and the whole procedure was repeated. The same was done with 300 mg of Ranitidine daily, 150 ml of Al-Mg antiacids daily, and at last, the same procedure was performed with the association of Ranitidine and Al-Mg antiacids at the mentioned dosage. For the statistical analysis of the data, the mean ordinate of the pH was used as a representative value of each individual's pH. Individual differences (pH with treatment minus pH without treatment) were obtained. The mean effect of each treatment was obtained averaging that differences. For comparison among different drugs, the same procedure was used. Student's paired t tests were performed in a signification level. The buffering capacity was measured in the following way: The percentage of the gastric secretion samples with pH equal or higher than 4 in each treatment and in the total number of patients was confronted with the results obtained in the same patients with no treatment. All the drugs were useful for buffering the gastric acidity, but in different intensity. The association of Ranitidine and Al-Mg antiacids showed to be the most efficient statistically when compared with Cimetidine and Al-Mg antiacids; no statistical difference appeared in the comparison with Ranitidine.

Adult↗
PubMed1982

Ultrasonic patterns of intrauterine fetal growth in a Latin American country.

Head circumference and its cross-sectional area, biparietal and fronto-occipital diameters, abdominal circumference and its cross-sectional area, and the transverse and anteroposterior diameters were measured in 30 healthy single fetuses from normal pregnancies by means of ultrasound. The 5th, 50th and 95th percentiles of distance and velocity curves are described. The comparison of the values of a perimeter (abdominal or cephalic) measured directly from the photograph or calculated by the ellipse formula, showed a straight correlation. The use of the ellipse formula in current practice may simplify and reduce the cost of this technology.

Abdomen↗
PubMed1979

HCS, estriol and oxytocinase in maternal serum and neonatal condition in high risk pregnancies.

In order to find a reliable index of fetal wellbeing, maternal estriol, hCS and oxytocinase levels were related with condition of the neonate. Fifty six high risk pregnancies were studied. Estriol and hCS were determined by specific radioimmunoassay and oxytocinase with a colorimetric method. The condition of the newborn was evaluated by the APGAR score. Neonates were divided into two groups, depressed (APGAR score 0-6) and vigorous (APGAR score 7-10). When the mean birthweights of both groups were statistically different, maternal estriol levels were corrected to avoid the influencing factor of newborn weight. Mean maternal estriol level corresponding to vigorous newborns was 46.73 ng/ml. This value was statistically higher than that corresponding to the group of depressed newborns, which was 26.25 ng/ml (Fig. 1). The mean birthweight of depressed infants (2,382.75 g) was statistically lower than that of the vigorous group (3,044.75 g). The corrected mean maternal estriol values of vigorous neonates (45.44 ng/ml) was different from that of depressed ones (25.14 ng/ml) (Fig. 2). When patients were divided according to maternal diseases (diabetes, vascular pathology, Rh sensitization) serum estriol levels of the mother were statistically different according to the Apgar score of the newborns. There was no significant difference between serum hCS and oxytocinase levels of mothers with depressed and vigorous newborns. Discarding fetal weight as an influencing factor in maternal hormone level, our results indicate the suitability of maternal serum estriol determinations to predict condition of the newborns in high risk pregnancies.

Aminopeptidases↗
PubMed1978

Early postnatal growth evaluation in full-term, preterm and small-for-dates infants.

Postnatal growth patterns of weight, length/height and head circumference in full-term (FTI), preterm (PTI) and small-for-dates (SFDI) infants, are described by using distance and velocity data together with the concept of growth per unit of body weight. The study was performed in 112 healthy Caucasian infants, of a similar socioeconomic status, in Montevideo, Uruguay. Median growth velocity (MGV) and median growth velocity per unit (MGVU) of body size are defined. The authors stress that: (a) growth velocity is related to body mass, (b) a useful evaluation of growth is made by using two consecutive measures with a certain time interval independently of birthweight and gestational age, and (c) expressing growth per day per unit relates well to daily nutritional and other requirements.

Age Factors↗
PubMed1976

Blood acid-base balance at birth in neonates from labors with early and late rupture of membranes.

The purpose of this study was to determine whether the early artificial rupture of the amniotic membranes performed to shorten the duration of an otherwise normal labor and delivery might have potentially deleterious effects on the fetus that would be reflected in the neonate. In 38 infants delivered at term, acid-base balances and O2 and CO2 pressures were obtained in umbilical arterial and venous blood at birth, prior to the first inspiration. For the purpose of the study the infants were divided into two groups: group I infants were born after a normal labor in which the amniotic membranes were permitted to rupture spontaneously at full cervical dilatation; group II infants were born after a labor in which the membranes were ruptured artificially when cervical dilatation was 4 to 5 cm. There was no evidence of fetal distress, and all infants were vigorous at birth. The pH of umbilical venous blood was greater in the group with late rupture of the membranes (fiftieth percentile [P50] = 7.36) than in those born after early amniotomy (P50 = 7.30) (p less than 0.01). The pH values of umbilical arterial blood were also higher in the group I infants (P50 = 7.31) than in those born after amniotomy (P50 = 7.25)(p less than 0.025). These differences were also observed in the 19 neonates in whom the cord was not encircled around the neck at the time of birth. The PCO2 in umbilical venous blood was less, and the hemoglobin saturation was greater (P less than 0.05) in group I infants than in those of group II. It is possible that the influence of early amniotomy on fetal pH may be deleterious in infants born after high-risk pregnancies in which the uteroplacental circulation is impaired.

Acid-Base Equilibrium↗
PubMedDate not supplied

[Cost-effectiveness of individualized enteral nutrition by a nutrition support team in laryngectomized cancer patients].

The purpose of this study was to evaluate the effectiveness of a Nutritional Support Team (NST) in the control and follow-up of enteral nutrition (EN) in patients subjected to laryngectomy as a result of neoplasia. The study was performed on two groups of patients (A and B) who had been admitted into the Otorhinolaryngological Department, and who required EN by nasogastric tube during the postoperative period. Group A consisted of 20 patients in whom EN was based on standard guidelines, with a daily intake of 11.1 g of Nitrogen and 2.000 kcals. Group B included 23 patients who received EN individually, using NST with a daily intake of Nitrogen of between 8 and 21 g, and energy intake of between 2.000 and 3.000 kcals. The total cost of nutrition was calculated using the following partial costs: diet, administration, laboratory analysis and NST head responsible for follow-up of Group B. Individualized EN was more effective in nutritional terms than a standard diet in all patients. Using this form of treatment, positive Nitrogen balance were achieved, levels of seric albumin were maintained as well as weight, and complications were reduced. The average cost of nutrition per patient in Group B was 46.258 pesetas and in Group A, 43.963 pesetas. However, in the latter Group, there was an average additional weight loss of 4 kg per patient, and an increase in cost effectiveness ratio of 573 pesetas in weight gained in Group B compared to Group A.

Adult↗