Biliary stents as temporary treatment for choledocholithiasis in pregnant patients.
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Adult↗
Biomedical subjects
G Rodriguez
Publications and source records attributed to G Rodriguez.
Chromosome damage and DNA repair response in lymphocytes of women who had children with neural tube defects.
Mothers who resided in Brownsville, Texas and who had children with neural tube defects (NTD) were studied to determine whether exposure to environmental mutagens may be a cause of abnormal reproductive outcomes. Peripheral blood lymphocytes from 19 of the mothers who had children with NTD and from 14 matched mothers who had normal children and who resided in Corpus Christ. Texas were investigated using the standard cytogenetic assay and a challenge assay to determine the existence of chromosome aberrations and abnormal DNA repair response. No differences were observed when the spontaneous and the challenged chromosome aberration frequencies were compared between the core and the control groups. Our data suggests that the core group was not exposed to mutagens at levels to cause significant increases of chromosome aberrations or to cause abnormal DNA repair response as determined by our assays. However, exposure to non-mutagenic environmental teratogens cannot be ruled out.
Adult↗
Psychometric properties of the Weekly Stress Inventory (WSI): extension to a patient sample with coronary heart disease.
The psychometric characteristics of the Weekly Stress Inventory (WSI) were examined in a sample of medical patients (N = 84) diagnosed with coronary heart disease. In addition to the WSI, patients completed measures assessing recent depressive symptoms, physical symptoms, Type A behavior, and trait anxiety. Patients also monitored stress for 3 weeks (n = 46), completing the Daily Stress Inventory (a measure of minor stress) daily and the WSI at concurrent 1-week intervals. Results indicated that the WSI is an internally consistent and moderately stable measure. Validity of the WSI was supported by (a) strong correlations with a concurrently administered measure of minor stress (concurrent validity); (b) significant positive correlations with measures assessing recent depressive symptoms, physical symptoms, and Type A behavior; and (c) a lack of relationship with a measure of trait anxiety (discriminant validity).
Adult↗
Cerebral haemodynamic changes induced by spinal cord stimulation in man.
Spinal cord stimulation (SCS) has been shown to influence cerebral perfusion in both experimental models and humans. With the aim of further verifying such an effect, twelve patients had an epidural (cervical or dorsal) lead inserted percutaneously and underwent regional cerebral blood flow (rCBF) examinations (133-Xenon inhalation method) before and during SCS. Mean blood velocity (MBV) in the middle cerebral artery was also measured in seven cases by means of transcranial Doppler. In the patients with a cervical lead, a symmetrical increase in rCBF was found, mainly in the anterior regions (from +8% to +21%). MBV increased in four cervical lead implants (from +16% to +20%) and in one case with a dorsal lead (+15%). These results suggest that cerebral perfusion may increase in patients undergoing SCS through a cervical lead. Although the mechanism involved in the increase in rCBF remains to be clarified, frontal lobe functional activation by the ascending reticular pathways through the thalamo-cortical projections might be hypothesised.
Adolescent↗
Prognostic significance of quantitative electroencephalography in Alzheimer patients: preliminary observations.
In 31 Alzheimer outpatients followed up for a mean time of 26.4 months the hypothesis that quantitative electroencephalography (qEEG) could predict the loss of activities of daily living (ADL), the onset of incontinence, and death was tested by the Weibull proportional hazard model of 'lifereg' procedure of the Statistical Analysis System package. A central-posterior temporal region was considered in either side (power-weighted, log transformed relative values). Right delta predicted both the loss of ADL and death, whereas right theta predicted the onset of incontinence. Left values gave borderline significant results toward all end-points, whereas power-weighted mean frequency always gave borderline results. The curves calculated for predicted times may be a valid support for the clinician in attempting prognostic judgments of disease evolution.
Aged↗
Iatrogenic outbreak of M. chelonae skin abscesses.
We describe an outbreak of skin lesions due to Mycobacterium chelonae subsp. abscessus associated with injections of lidocaine (lignocaine) given by a 'bioenergetic' (a practitioner of alternative medicine) in Colombia. The lidocaine carpules and the lesions of the patients yielded mycobacteria with identical biochemical characteristics. Using the methodology of Sartwell and a case control design we examined the incubation period and assessed risk factors. Of 667 potentially exposed individuals, a total of 298 patients were interviewed, of whom 232 had skin lesions. The median incubation period was 30.5 days (range 15-59 days). Male sex (OR 2.85, 95% CI 1.26-6.51), increasing age (OR 1.25, 95% CI 1.03-1.53), subcutaneous injection route (OR 3.72, 95% CI 1.09-12.7) and number of injections (OR 1.01, 95% CI 1.00-1.03) were risk factors for disease. To our knowledge, this is the largest reported outbreak of M. chelonae infection, the first in which the organism has been isolated from the putative vehicle of infection, and the first in which the incubation period could be determined.
Adolescent↗
In-vitro activity of antimicrobial agent combinations against multiresistant Acinetobacter baumannii.
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Acinetobacter↗
A phase I clinical and pharmacokinetic study of the angiogenesis inhibitor, tecogalan sodium.
BACKGROUND: Tecogalan sodium is an angiogenesis inhibitor isolated from a sulfated polysaccharide produced by the bacterium Arthrobacter. The antiangiogenic effect of tecogalan sodium is thought to be mediated by the inhibition of binding of basic fibroblast growth factor to cellular receptors. PATIENTS AND METHODS: A phase I study was conducted in thirty-three patients with refractory malignancies, including AIDS-associated Kaposi's sarcoma. Patients received a single i.v. infusion every three weeks with the infusion duration ranging from one to twenty-four hours. Seven different dosage levels were studied (125, 185, 240, 300, 390, 445, and 500 mg/m2). RESULTS: The primary dose-limiting toxicity was prolongation of the activated partial thromboplastin time with peak times being between 1.0-4.0 times the upper limit of normal. This toxicity was ameliorated at a given dose level by prolonging the infusion time. Other common toxicities included fever (40%) and rigors (31%) which were well controlled with acetominophen and meperidine. The serum half-life of tecogalan sodium was between 1-1.5 hours and < 25% of unchanged drug was excreted in the urine. CONCLUSIONS: The recommended phase II dose of tecogalan sodium on this schedule is 390 mg/m2 over 24 hours. Other schedules including continuous administration should be investigated to maximize the efficacy of this novel angiogenesis inhibitor.
Antineoplastic Agents↗
Cerebral blood flow reserve in patients with syndrome X.
BACKGROUND: Patients with syndrome X frequently show disorders of oesophageal motility, bronchial reactivity or impaired vasodilator capacity of peripheral vascular beds. For these reasons, it has been suggested that syndrome X may represent a generalized abnormality of vascular and non-vascular smooth muscle function, rather than an isolated coronary problem. OBJECTIVE: To measure the cerebral blood flow and cerebrovascular vasodilator reserve in syndrome X patients and in controls. METHODS: We measured the cerebral blood flow and cerebrovascular reserve in 16 patients with syndrome X [11 women, aged 59.5 +/- 10.8 years (mean +/- SD)] and in 16 age-matched healthy volunteers. No patients had evidence of stenoses of carotid and vertebral arteries on Doppler sonography. Cerebral blood flow was measured by the 133Xe inhalation method, using the initial slope index as the cerebral blood flow index. After a baseline measurement, a second cerebral blood flow measurement was performed 20 min after administration of 10 mg/kg acetazolamide intravenously. Acetazolamide is known to be a potent cerebral vasodilator. The percentage increase in cerebral blood flow after acetazolamide administration was considered an index of cerebrovascular vasodilator reserve. RESULTS: Under basal conditions, both regional and global cerebral blood flow were nearly identical in the control group and in the patient group (initial slope index 50.2 +/- 3.8 versus 50.3 +/-6.2, NS). After acetazolamide administration, the cerebral blood flow increase was 29.0 +/- 14% in the patient group and 29.5 +/- 11% in the control group (NS). CONCLUSIONS: Our data show that cerebral blood flow and cerebrovascular vasodilator reserve were preserved in a series of patients with syndrome X. These results are not consistent with the hypothesis of a diffuse smooth muscle disorder.
Acetazolamide↗
Quantified-EEG in normal aging and dementias.
The value of quantitative electroencephalography (q-EEG) in the differential diagnosis of multi-infarct dementia (MID) and dementia of Alzheimer's type (DAT) is controversial. To evaluate the possible diagnostic role of q-EEG in these two conditions we studied 18 healthy adults, 16 healthy elderly (HE), 29 DAT patients and 45 MID patients. MID patients showed a significant increase of delta activity on the occipital regions, a significant widespread increase of theta activity, a significant widespread decrease of alpha activity. DAT patients showed a significant widespread increase of delta and theta activity, a significant widespread decrease of alpha activity. Spectral profile analysis showed an asymptotic exponential peak frequency at 4.33 HZ, and the disappearance of dominant activity in DAT patients; a 1 Hz decrease of peak frequency with a preserved normal profile in MID patients. We conclude that q-EEG is a useful ancillary test to differentiate MID from DAT.
Aged↗
Bone mineral density in patients with hypercalciuric nephrolithiasis.
Bone mineral density was studied in 50 adult patients with renal lithiasis and metabolic diagnosis of idiopathic hypercalciuria. Thirty were premenopausal women and 20 were men under 55 years of age, Bone density at the lumbar spine (LSBD) was 0.940 +/- 0.106 g/cm2 in the hypercalciuric patients compared to 1.112 +/- 0.037 g/cm2 in a cohort of age- and sex-matched controls (p < 0.001). LSBD was independent of age and was negatively correlated with the duration of stone disease (r = -0.52, p < 0.001). Thus we conclude that patients with idiopathic hypercalciuria have a decrease in their LSBD that is probably related to a negative calcium balance sustained over time.
Adult↗
Accuracy of 133-xenon regional cerebral blood flow and quantitative electroencephalography in systemic lupus erythematosus.
OBJECTIVE: Comparative assessment of sensitivity and specificity of regional Cerebral Blood Flow (rCBF) by 133-Xenon inhalation and quantitative Electroencephalography (qEEG) in patients with Neuropsychiatric Systemic Lupus Erythematosus (NP-SLE). METHODS: Sixty-two combined rCBF and qEEG examinations were performed in fifty-two SLE patients. Group A: 27 SLE patients without NP-SLE; group B: 17 patients with florid (within 1 month) NP-SLE; group C: 12 patients previous NP-SLE examined in the remission phase (four patients of which already considered in group B). The study also included data deriving from two sets of examinations in ten patients who were observed twice, in different phases of the clinical course of NP-SLE. RESULTS: In comparison to healthy controls, rCBF lower (p < .001) in group B only, whereas qEEG showed similar increases of both delta and theta relative powers together with a reduction of alpha relative power in groups A-C. As compared to group A, sensitivity and specificity in detecting cerebral abnormalities in group B were 76% and 78% for rCBF, and 59% and 44% for qEEG, respectively. In the ten patients examined twice, rCBF was consistent with clinical course in 90% of cases and qEEG in 60%. CONCLUSION: Total accuracy in detecting cerebral functional abnormalities during florid NP-SLE is better by rCBF than by qEEG. rCBF and, in selected cases, qEEG examinations are reliable markers of NP-SLE.
Adolescent↗
Cerebral hyperperfusion antedates by years strokelike episodes in the MELAS syndrome.
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Adult↗
Long and short gracilis myocutaneous flaps for vulvovaginal reconstruction after radical pelvic surgery: comparison of flap-specific complications.
The purpose of this study was to determine the factors associated with flap-specific complications in patients receiving gracilis myocutaneous flaps for pelvic reconstruction, specifically to determine whether the short gracilis flap increases the risk of major flap loss. Records of consecutive women undergoing gracilis flap pelvic reconstruction procedures were analyzed retrospectively. Twenty-two received classical "long" flaps, while 24 received short flaps. In the short gracilis flap modification, the dominant vascular pedicle is deliberately sacrificed. Clinical factors for association with flap-specific complications were analyzed. Eighty-three flaps were used in 46 women for reconstruction after radical pelvic surgery. Those receiving short flaps were more likely to have a preoperative diagnosis of cervical cancer and to have undergone exenteration with rectosigmoid anastomosis, and all short flaps were performed by gynecologic oncologists (all P < 0.05). Distribution of other patient characteristics were similar. Loss of more than one or both flaps occurred in seven (15%) patients, three (14%) with long and four (17%) with short flaps, a nonsignificant difference. Age, weight, tobacco use, associated medical conditions, diagnosis, prior therapy, type of procedure, previous lymphadenectomy, use of bilateral flaps, postoperative abscess/fistula, and type of surgeon were not significantly associated with major flap loss. Four (50%) of eight patients undergoing exenteration with rectosigmoid anastomosis had major flap loss, compared to 2 of 29 with exenteration only, and 1 of 9 with other pelvic reconstructions (P < 0.05). In conclusion, sacrifice of the dominant vascular pedicle in the short gracilis flap does not increase the risk of major flap loss. Vaginal reconstruction after exenteration with rectosigmoid anastomosis significantly increases the risk of this complication.
Adult↗
Etoposide-platin combination therapy for chemorefractory gestational trophoblastic disease.
The purpose of this study was to determine activity of etoposide-platin combination chemotherapy for chemorefractory gestational trophoblastic disease. A retrospective review of patients treated with etoposide-platin chemotherapy for chemorefractory trophoblastic disease was conducted. Patients received etoposide 100 mg/m2 and cisplatin 20 mg/m2 on Days 1 through 5 of 14- to 21-day cycles. Patient characteristics, responses, and toxicity were recorded. Seven women received etoposide-platin for chemorefractory disease. The median WHO prognostic index score upon initiation of therapy was 16 (range, 10-20) and patients had received a median 6 cycles of prior combination chemotherapy. Five patients developed grade IV neutropenia, four developed neutropenic sepsis, and two required platelet transfusions. Two patients developed significant deterioration of renal function. Six (86%) patients had complete responses, with normalization of hCG values, but only three (43%) patients with low pretherapy hCG levels have had sustained remissions. Etoposide-platin chemotherapy is an active regimen for the treatment of women with chemorefractory gestational trophoblastic disease but has significant hematologic and renal toxicity when used as salvage therapy. Future studies should investigate the incorporation of etoposide-platin into initial therapy of women with high-risk disease.
Adult↗
Natural killer cell acute leukemia with myeloid antigen expression. A previously undescribed form of acute leukemia.
An acute leukemia of natural killer cell origin with myeloid antigen expression has not previously been described in the literature. Although lymphoproliferative disorders of large granular lymphocytes may be of natural killer cell origin and may have an aggressive clinical course, the morphology in the blood and bone marrow is that of large granular lymphocytes. An acute leukemia with blastic morphology is described, which was of natural killer cell origin by flow cytometric immunophenotyping (CD45+, CD2+, CD3, CD7+, CD5+, CD4, CD8, CD56+, CD57, CD16, CD13+, CD33+, CD34+, C-Kit+, HLA-DR, TdT) and histochemical staining. This was supported by the lack of T-cell gene rearrangement. The patient had an aggressive clinical course despite therapy for acute lymphoblastic leukemia. The authors recommend routine flow cytometric immunophenotyping of acute leukemia to identify other similar cases to better clinically define this entity.
Acid Phosphatase↗
Assessment of regional cerebral blood flow during spinal cord stimulation in humans.
Increased cerebral perfusion has been reported in both animal models and humans undergoing spinal cord stimulation (SCS). However, this was an inconsistent finding and variables able to influence regional cerebral blood flow (rCBF) following SCS are poorly investigated. We report our experience on rCBF measurements by the xenon-133 inhalation technique in 20 patients receiving acute and chronic SCS for different pathologies in basal conditions. Neither acute nor chronic SCS induced significant rCBF changes in the group of patients as a whole. However females, non-atherosclerotic patients and patients with a cervical SCS lead, showed a trend (borderline statistical significance) toward a redistribution of rCBF with increased values in frontoprerolandic and decreased values in postrolandic regions. Although SCS appears to influence intracerebral distribution more than absolute changes in blood flow, the mechanisms underlying such a phenomenon remain unknown. Functional activation of frontal lobes by the ascending reticular pathways through the thalamofrontal projections could be one possible hypothesis which has to be confirmed by further studies.
Administration, Inhalation↗