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Biomedical subjects

F Trujillo

Publications and source records attributed to F Trujillo.

At least 19 recordsLinked to original sources
PubMed2001

Colombian study to assess the use of noninvasive determination of endothelium-mediated vasodilatation (CANDEV). Normal values and factors associated.

The endothelium plays a critical role in vascular homeostasis. Recently, a noninvasive method has been developed to assess flow mediated vasodilatation of the brachial artery (FMD). This test is remarkably stable overtime but no clear set of normal values has been developed. The purposes of our study were to evaluate the accuracy and reproducibility and to identify a set of normal values of FMD. We included 253 normotensive healthy volunteers from three Colombian cities (mean age: 38.2 years; 33% were women). All subjects underwent ultrasound evaluation of endothelial and smooth muscle function. Flow mediated vessel diameter change was measured by two independent observers. The interobserver Lin's concordance correlation coefficient was 0.88% (95% CI: 0.82, 0.94) and there was no evidence of systematic difference between the two measurements (mean difference of -0.30% with limits of agreement of -4.48 to 3.87). Mean %FMD was 11.98% (95% CI: 11.36, 12.61), 13.32% (95% CI: 12.39, 14.25) in women and 11.32% (95% CI: 10.52, 12.13) in men. Subjects with no cardiovascular risk factors had a mean %FMD of 13.74% (95% CI: 13.14, 14.35), in contrast to a mean of only 7.40% (95% CI: 4.33, 9.91) in those with at least one risk factor. A %FMD cut point of 10.4 had a sensitivity of 71.2% and an specificity of 77.2% to identify subjects with at least one cardiovascular risk factor. Using this cut point, endothelial dysfunction was 3.13 times more frequent in subjects with than in subjects without cardiovascular risk factors (95% CI: 2.30, 4.25). In addition, obesity, smoking and hypercholesterolemia were the modifiable risk factors with largest independent significant reduction effects on %FMD. FMD measurements can be made with high accuracy and precision, and a cut point of 10.4% is useful to discriminate between subjects with and without cardiovascular risk factors, and can be recommended as a screening test for the detection of patients at risk of CVD.

Adult↗
PubMed1999

Genetic diversity and population structure of Vibrio cholerae.

Multilocus enzyme electrophoresis (MLEE) of 397 Vibrio cholerae isolates, including 143 serogroup reference strains and 244 strains from Mexico and Guatemala, identified 279 electrophoretic types (ETs) distributed in two major divisions (I and II). Linkage disequilibrium was demonstrated in both divisions and in subdivision Ic of division I but not in subdivision Ia, which includes 76% of the ETs. Despite this evidence of relatively frequent recombination, clonal lineages may persist for periods of time measured in at least decades. In addition to the pandemic clones of serogroups O1 and O139, which form a tight cluster of four ETs in subdivision Ia, MLEE analysis identified numerous apparent clonal lineages of non-O1 strains with intercontinental distributions. A clone of serogroup O37 that demonstrated epidemic potential in the 1960s is closely related to the pandemic O1/O139 clones, but the nontoxigenic O1 Inaba El Tor reference strain is not. A strain of serogroup O22, which has been identified as the most likely donor of exogenous rfb region DNA to the O1 progenitor of the O139 clone, is distantly related to the O1/O139 clones. The close evolutionary relationships of the O1, O139, and O37 epidemic clones indicates that new cholera clones are likely to arise by the modification of a lineage that is already epidemic or is closely related to such a clone.

Animals↗
PubMed1998

[Medical care costs for HIV-positive and AIDS patients in four hospitals in Santiago, Chile].

BACKGROUND: Medical care of HIV infected and AIDS patients may represent an important economical burden for public hospitals. AIM: To assess direct and indirect costs of medical care for HIV infected and AIDS patients in public hospitals of the Metropolitan Region of Chile. MATERIAL AND METHODS: Between August 1994 and February 1995, information about outpatient and hospitalized medical care of 417 HIV infected patients was gathered (representing approximately 16% of the seropositive population). Patients were divided as having or not having AIDS. The latter were those included in groups I, II, III and category C2 of group C (group 4). The cost of medications, procedures and examinations of these patients was calculated. RESULTS: Thirty six percent of studied patients had AIDS. The annual cost of care for AIDS patients was US$3760 compared to US$1450 for HIV infected patients without AIDS. Medications represented 75% and 65% of total costs in patients with and without AIDS respectively. The figures for examinations and procedures were 17% and 22% and for medical attentions were 7.5% and 8.8% respectively. CONCLUSIONS: Medical care of patients with AIDS has higher costs than that of HIV infected patients without AIDS. Thus, the retardation of the progression of the disease would have social, humanitarian and economical benefits. Our costs are similar to those of other countries with a similar level of economic development.

Acquired Immunodeficiency Syndrome↗
PubMed1996

[Usefulness of cerebral biopsy in focal cerebral lesions in patients with human immunodeficiency virus infection].

Brain mass lesions (BML) occurred in 10% of patients infected by the human immunodeficiency virus (HIV), as expression of severe and sometimes treatable diseases. However, the management of them is not well established. We analyzed, retrospectively, 26 brain biopsies (22 estereotaxic) in patients with HIV infection and BML to know their usefulness and safety. The inclusion criteria were: Failure of the anti-Toxoplasma empirical treatment, atypical scan appearance for toxoplasmosis, or severe neurological picture. Brain biopsy yielded a diagnosis in 19 patients (73.1%): Progressive multifocal leukoencephalopathy (n = 8; 30.8%), primary central nervous system lymphoma (n = 6; 23.1%), mycobacteriosis (n = 2; 7.7%), toxoplasmosis (n = 2; 7.7%), criptococcosis (n = 1), cryptosporidiosis (n = 1) and HIV-encephalitis (n = 1). In one case there was a multiple diagnosis: mycobacteriosis, toxoplasmosis, and lymphoma. Brain biopsy results decided a change in therapy in 65.4%, the resolution or improvement of the neurological process in 30.8%, and the determination of the prognosis in 30.8%. In 8 cases (30.7%) there were biopsy complications, with secondary mortality in one. Brain biopsy of BML in HIV-infected patients is a diagnostic method with a high overall diagnostic rentability and uncommon non reversible complications, offering the possibility to prescribe a specific and potentially curative treatment.

Adult↗
PubMed1996

[A new classification of lower infarcts with important prognostic significance].

BACKGROUND: The initial therapy of acute myocardial infarction is often determined by the electrocardiogram. OBJECTIVE: To evaluate a classification of inferior myocardial infarctions according to the first electrocardiogram. DESIGN AND SETTING: Prospective study in a coronary care unit. PATIENTS: 116 patients admitted due to a first acute myocardial infarction of the inferior wall. METHODS: "Type 1" electrocardiogram was defined as ST segment elevation without distortion of the QRS. Patients were considered "type 2" when, besides ST segment elevation, they presented a distortion of the terminal portion of the QRS complex in two inferior leads. MAIN RESULTS: Twenty-nine patients (25%) were considered "type 2". These patients were older and had worse Killip class than "type 1". The mortality rate was 1.2% in "type 1", and 24.1% in "type 2" (p = 0.0002). After multivariate analysis, which included Killip class, age, smoking, type of electrocardiogram and fibrinolysis, the type of electrocardiogram remained significantly predictive of death (p = 0.014). CONCLUSIONS: We conclude that "type 2" electrocardiogram is an independent predictor of adverse outcome in inferior infarctions. Further investigation is needed concerning its implications in the clinical management of these patients, although reperfusion therapy is warranted.

Adult↗
PubMed1994

[Long-acting and repeatable dose bromocriptine in the prolonged treatment of prolactinoma].

BACKGROUND: The presentations of intravenous or depot bromocriptine (bromocriptine LA or long acting, Pariodel LA and bromocriptine LAR or long acting repeatable, Pariodel LAR) have improved the efficacy and the tolerance of oral bromocriptine. In contrast to bromocriptine LA, bromocriptine LAR may be repeatedly administered intramuscularly. METHODS: Five patients with macroprolactinoma and 4 with microprolactinoma were included in the study. A 50 mg bottle of bromocriptine LAR was administered intramuscularly every month, over a minimum period of 6 months. PRL was determined prior to the study, 1, 3, 7, 14, and 28 days following the initial dose of bromocriptine and thereafter with monthly periodicity. RESULTS: The PRL values decreased in those patients with macroprolactinomas following the administration of bromocriptine LAR; in 2 patients the monthly doses of bromocriptine LAR was increased to 100 mg since the month after the initial dose PRL remained greater than 200 ng/ml with serum RPL normalizing in most of the patients at 6 months of treatment. In two of the three patients who presented visual changes a clear improvement was observed and in all the cases a reduction in the size of the macroprolactinoma was found upon CAT control at 6 months. The PRL values also decreased in the patients with microprolactinomas following administration of bromocriptine LAR, although the response was not as homogeneous as in the patients with macroprolactinomas due to that at 6 months 2 patients continued to have slightly elevated serum PRL levels. The microadenoma persisted in the control CAT at 6 months except in one case. Local and general tolerance to bromocriptine LAR was very good. CONCLUSIONS: This study indicates good tolerance to bromocriptine LAR, being a therapeutic option in the treatment of macroprolactinomas.

Adult↗
PubMed1993

Clinical use of octreotide in unresectable meningiomas. A report of three cases.

Unresectable meningioma is the cause of a serious clinical problem, for whom no satisfactory mode of treatment is currently available. Meningiomas are known to have receptors for diverse hormones. In this sense, somatostatin receptors were found in every meningioma specimen studied in a recent report. In addition, somatostatin has been able to inhibit meningioma cell proliferation in vitro. A brief report of clinical use of somatostatin long-life analogue octreoctide upon three patients diagnosed of unresectable meningioma is here presented. Doses used were gradually increased up to 1000, 900 and 1500 micrograms/24 h during 16, 6 and 7 weeks, respectively. There was an almost perfect tolerance to the drug (in one case a mild and transient abdominal discomfort and diarrhea could be observed). An important alleviation of headaches in 2 cases, and a transient but objective improvement in ocular movements and signs in 1 case were noticed. No change (neither growth nor shrinkage) was observed by CT scan at the end of treatment course in the three cases studied. In 1 case a partial resection was performed and tissue specimen was found to contain somatostatin receptors. Although in our very limited experience no brilliant results are presented, duration of treatment or doses used could have been insufficient. Data herein presented seem to support recently reported findings in which no growth inhibition of meningioma cells cultured in vitro by adding octreoctide to the medium was observed. So, in our opinion, clinical use of octreoctide on unresectable meningioma deserves further experience, that must be carried out with great caution.

Adult↗
PubMed1992

Population, labour force and unemployment in Andalusia: prospects for 1993.

"This paper is concerned with forecasting population, employment, labour force and unemployment in Andalusia [Spain] to 1993. For this purpose, a block-recursive demoeconomic model is presented. The demographic submodel is based on the component-cohort method of forecasting population by age and sex. The economic submodel uses econometric and time series analysis to forecast employment both in the medium and short-term. In the labour market part, the labour force is forecasted taking into account the encouraged-discouraged worker effects of changes in the demand for labour."

Age Factors↗
PubMed1990

[Treatment of macroprolactinomas with delayed bromocriptine. Effectiveness of a single intramuscular injection].

The aim of the present study was to evaluate the effectiveness and tolerance of a new pharmaceutical preparation of long acting bromocryptine (bromocryptine depot of L.A.), characterized by the slow release of bromocryptine during 4 or 6 weeks after a deep intramuscular injection. It was administered to 9 patients with macroprolactinoma, 7 of which had visual abnormalities. The tolerance of the drug was excellent, and only one patient had nausea within the first 24 hours. In all cases, PRL values fell between 40% and 97%. All patients with visual abnormalities, including 2 patients with cranial nerve palsy (IIIth and VIIth pairs) returned to normal or improved. In the CT controls carried out after 4 weeks of therapy a reduction in tumor size was observed in 7 of 9 patients. Two patients were operated through the transesphenoidal route, PRL being demonstrated in the immunohistochemical study of the resected specimen. Subsequently, all patients received oral bromocryptine therapy with perfect tolerance. The results show that parenteral long acting bromocryptine is an effective, well tolerated and convenient way to start the therapy of macroprolactinoma, even when severe visual abnormalities are present.

Adolescent↗
PubMed1990

A study on the venous drainage of 150 cerebral arteriovenous malformations as related to haemorrhagic risks and size of the lesion.

In this paper we study the venous drainage of 150 cerebral arteriovenous malformations (AVM), correlating the number of efferent veins with the symptoms of clinical onset and with the size of the lesions. Statistical analysis demonstrates that those AVM's which in the angiograms show only one draining vein have a high risk of haemorrhage. As the number of drainage veins increases, this bleeding risk decreases, becoming quite low in angiomas with multiple drainage veins, which we denominate "medusa-head angiomas". Statistics also demonstrate that small angiomas (less than 2 centimeter on diameter) usually have only one drainage vein, thus carrying a high risk of haemorrhage. As their size increase, so do the number of veins, and the possibility of haemorrhage decreases.

Adolescent↗
PubMed1990

Risk of diarrhea during the first year of life associated with initial and subsequent colonization by specific enteropathogens.

The incidence of colonization by enteropathogenic, enterotoxigenic, enteroinvasive, and enterohemorrhagic Escherichia coli (detected by DNA hybridization with specific radiolabeled probes), Salmonella sp., Shigella sp., Campylobacter jejuni, and rotavirus was related to the presence of diarrhea in a cohort of 75 rural infants followed longitudinally during the first year of life. The study was carried out between August 1985 and February 1987 in the village of Lugar Sobre la Tierra Blanca, in the state of Morelos, 180 km southwest of Mexico City. Intestinal colonization by specific enteropathogens was followed with fecal cultures taken every fortnight and every time a child had diarrhea. Pathogens isolated from cultures taken in the 48 hours prior to the initiation of the diarrheal episode were considered to be associated with the disease. Diarrhea was detected in 82% of the children with initial isolation of enterohemorrhagic E. coli and in 64% of the children with enteropathogenic E. coli or Shigella sp. The risk of diarrhea associated with the initial isolation of other pathogens was lower, at 41% for rotavirus and approximately 25% for enterotoxigenic E. coli, Salmonella sp., and C. jejuni. Initial colonization by the enteropathogens studied, whether or not they were associated with diarrhea, prevented disease, but not colonization by the same organism, when the children were reinfected during the first year of life. Enteropathogenic E. coli adherence factor, human or porcine heat-stable enterotoxins, fimbrial colonization factor antigens, and Shiga-like toxins I and II were important pathogenic characteristics related to the presence of diarrhea and to protection against subsequent infection by the same organisms.

Campylobacter Infections↗
PubMed1990

Evaluation of the pituitary-adrenal axis before, during and after pituitary adenomectomy. Is perioperative glucocorticoid therapy necessary?

Under the supposition that ACTH secretion will be compromised by surgical trauma, patients with pituitary adenomas undergoing transsphenoidal adenomectomy are frequently given corticoids, even though this therapy is controversial. We studied 10 patients with pituitary adenomas whose adrenocortical function was sufficient prior to surgery. The ACTH and cortisol levels rose significantly during surgery in all of these patients. Five patients completed a two-year postoperative follow-up period and their ACTH and cortisol values remained within normal limits. It may be that patients undergoing transsphenoidal surgery for pituitary adenomas do not need perioperative glucocorticoid treatment, since the hypophyseal-adrenal axis does retain its integrity.

Adenoma↗
PubMed1989

Rapid improvement of visual defects with parenteral depot-bromocriptine in a patient with a non-functioning pituitary adenoma.

The management of non-functioning pituitary adenomas with bromocriptine is controversial, and surgical treatment is usually prescribed when the visual field is affected. Here we report, what we believe to be the first case of a patient with a non-functioning pituitary adenoma who experienced normalization of visual field defects and a substantial improvement in visual acuity after the parenteral administration of depot-bromocriptine. The patient's tolerance to the drug was excellent. The results of the immunohistochemical study of the surgically removed tumor were negative for PRL, GH, LH, FSH, TSH and ACTH. In our opinion, the use of depot-bromocriptine may represent an alternative to surgery in patients with non-functioning pituitary adenomas associated with visual lesions.

Adenoma↗
PubMed1988

Treatment of carotid-cavernous fistulas by embolization of the cavernous sinus through venous affluents or direct puncture.

Eight patients with nine carotid-cavernous fistulas (CCF), one of them bilateral, have been treated in our Department by embolization of the venous components of the cavernous sinus, either through one of its venous effluents or by direct puncture of the sinus, in an effort to preserve the internal carotid artery (ICA). Five of the fistulas were of traumatic origin and four were spontaneous. In two cases the cavernous sinus was embolized through bridging temporal veins, and in another two cases embolization was carried out by catheterization of the cavernous sinus via the superior ophthalmic vein, while in the remaining five cases it was performed by direct puncture of the lateral wall of the sinus. The embolizing materials employed were bone wax mixed with an oily iodised contrast media, small pieces of oxidized cellulose or gelfoam vehicled by saline solution, and fibrin sealant. Obliteration of the CCF was complete in all but one case, in which this was accomplished only partially. On six occasions carotid patency was maintained, while in two patients failure of the technique made trapping of the ICA necessary. In one patient the ICA was ligated prior to the embolization of the cavernous sinus. The surgical techniques employed and the results achieved are exposed.

Adult↗
PubMed1988

Direct carotid sinus approach to treatment of bilateral carotid-cavernous fistulas. Case report.

The authors present a patient with a complex vascular malformation composed of bilateral spontaneous carotid-cavernous fistulas (CCF's). The abnormality was supplied on the right side by the right external carotid artery (ECA) and the right internal carotid artery (ICA), and on the left side only by the left ICA. There was also an arteriovenous communication between the right ECA and the lateral sinus. Surgical embolization of both cavernous sinuses with oxidized cellulose was achieved on one side by direct puncture and on the other through one of its venous affluents, successfully occluding both CCF's and preserving the patency of both ICA's without any neurological deficit. The arteriovenous communication between the right ECA and the lateral sinus was occluded by embolization of the occipital artery and ligation of the right ECA.

Arteriovenous Fistula↗