Weight gain between dialyses in diabetics: possible significance of raised intracellular sodium content.
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Body Weight↗
Biomedical subjects
H Hinestrosa
Publications and source records attributed to H Hinestrosa.
[Acute pancreatitis: the value of ultrasonography in its prognosis].
As acute pancreatitis is a disease of unpredictable outcome, we wanted to use an available diagnostic method such as ultrasonography, in order to establish the prognosis of this problem. There are some published papers using CT scan as prognostic value of this disease but none about ultrasonography. We evaluated 34 patients with clinical diagnosis of acute pancreatitis based on abdominal pain, nausea, vomits and absence of abdominal sounds plus an elevation of amylases of at least three times above the normal value. An abdominal ultrasound was performed at admission and every 4 days or even sooner if complications were suspected. Acute pancreatitis was classified by clinic and ultrasound in mild, moderate and severe. From 34 patients studied, 27 were clinically and by ultrasound correlated (79%) giving a sensibility of 100% and a specificity of 85%, without false positives. There were some cases in which ultrasound detected abnormalities before clinical manifestations, so a close follow up was done and this allowed us to be ready if any complications showed up. Follow up with ultrasound examination was very useful, permitted us to detect early complications with or without clinical manifestations and also emphasized that a single ultrasound examination is not enough as a prognostic or diagnostic method.
Acute Disease↗
[Liver cirrhosis: pulmonary function].
We performed a functional respiratory examination which consisted of arterial gasometry, spirometry, diffusion capacity to CO2, alveolo-arterial gradient of O2 and pulmonary volumes to 8 patients with cirrhosis diagnosed by clinical history, laboratory exams, abdominal ultrasound and histology. Our results showed a slight obstructive pattern of peripheric airways (FMM: 88.87 +/- 8.7%) in the spirometry, no difference in arterial gases at upright and recumbent position was observed, with low values of apO2 (75.51 +/- 1.16 upright and 75.87 +/- 2.16 mmHg recumbent) without statistic significance. The gradient G(Aa) O2 increased to (30.89 +/- 1.06 mmHg). Besides there was a diffusion abnormality with a DLCO2/VA of (71.87 +/- 6.05%). Breathing 100% O2, did not change the gradient which allows us to postulate the existence of an abnormality of gaseous interchange due to shunts. We found no relationship between albumin levels and DLCO2/VO neither with pO2 in upright position; there was a relationship at recumbent position between the hepatic disorder and the arterial desaturation. We concluded that there is no significant hypoxia even with position changes, there is increase of G (Aa) O2 by shunt type disorders and that this is probably related with albumin levels.
Adult↗
[Diagnosis of tumor or metastasis in the liver by means of laparoscopy and gammagraphy].
Fifty-four patients with proven malignancy of the gastrointestinal tract or suspicion of primary or metastatic hepatic carcinoma were studied to evaluate the effectiveness of different diagnostic methods. Gammagraphic and laparoscopic evaluations were emphasized. The results indicated that laparoscopy was the most effective method for diagnosing primary or metastatic neoplastic liver disease.
Adult↗
[Double-blind evaluation of a benzodiazepine compound (lorazepam) as premedication in upper digestive endoscopy].
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Anti-Anxiety Agents↗
[Sclerotherapy with 75% ethanol in the control of hemorrhage caused by peptic ulcer disease].
We present our experience using ethanol as sclerosant of non-variceal bleeding lesions of the upper digestive tract and the result of its hemostatic effect when compared with patients who received conventional medical treatment. Since January 1989, 48 patients admitted with active bleeding or signs of high risk for rebleeding (clot or visible vessel) were submitted to sclerosis. The historic control group included patients admitted before 1989, being both groups comparable in clinical and endoscopic characteristics. Surgery was performed in 5 cases of the sclerosis group (10.4%) versus 14 of the control group (37.8%). Five of the patients in the sclerotherapy group died, one of them due to upper G.I. bleeding as the primary cause. We dit not observe a statistically significant difference in hospital stay, transfusion requirements or mortality. There were no complications as a result of the method. Sclerotherapy was not immediately effective in 2 patients; three patients who rebled were subject to new sclerosis, which was effective in controlling bleeding in two of them. In conclusion, sclerosis is a safe and effective method to achieve hemostasis, diminishing the re-bleeding and the need for surgery in cases of digestive bleeding due to peptic ulcer disease. Future studies using larger samples could show decrease in mortality.
Adolescent↗
[Clinical and prognostic factors of mortality in upper digestive hemorrhage].
In order to investigate prognostic factors we prospectively followed 741 patients with upper gastrointestinal bleeding (UGIB). Eleven variables were identified with mortality predictive value. Hematemesis, age of 50 y/o, more than 120 heart beat/minute, 3 or more units of pack red blood cells, esophageal varices, cirrhotic liver and renal failure had independent predictive value. Our findings could help to identify high risk patients.
Age Factors↗
[Upper gastrointestinal hemorrhage. Prospective analysis of 741 cases].
A prospective study was performed to evaluate the epidemiological characteristics and clinical outcome of patients with upper digestive bleeding. Between April 1987 and May 1993, 741 patients, 517 men and 224 women, with a mean age of 50.48 years (range, 12 to 94) were admitted to the emergency department with this diagnosis. The chief complaint was tarry stool (88.4%). A total of 717 patients underwent endoscopic examination within a mean time of 17.2 hours of arrival at the emergency department. Duodenal ulcers were found in 216 (35.9%) patients, gastric ulcer in 240 (32.4%), gastritis in 74 (10%), esophageal varices in 38 (5.1%), and other causes in 121 patients (16.5%). 478 required blood transfusion (range of 1 to 15 blood units transfused). 80.4% of patients who died necessitated transfusion versus 62.5% of the patients who had a satisfactory outcome. A total of 672 cases (92%) were managed with medical therapy. In 90 cases (12.2%) endoscopic injection treatment with 75% alcohol was performed. 60 patients (8.18%) had surgical therapy, 81.7% of whom underwent emergency operation to arrest bleeding. The global mortality was 10.6% (78 of 741 patients), compared to 18.3% in patients who were operated. The highest mortality occurred in patients with esophageal varices. We conclude that peptic ulcer is still the mayor cause of upper digestive bleeding. The high mortality found in patients who required surgical therapy creates the need to select those patients who may get benefits of alternate therapies which may improve the outcome.
Adolescent↗