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I Muñoz

Publications and source records attributed to I Muñoz.

51 records · Page 3Linked to original sources

[Iso-Kikuchi syndrome. 2 familial cases].

We report two familial cases of Iso-Kikuchi sindrome, (mother and son). Patient one with small bone abnormalities under mycronychya, and patient two with atopic dermatitis. Literature cases are reviewed.

Adult↗

Behavioural and histological effects of atrazine on freshwater molluscs (Physa acuta Drap. and Ancylus fluviatilis Müll. Gastropoda).

This study examines the direct and indirect effects of atrazine on two grazer species--Physa acuta and Ancylus fluviatilis--as assessed by changes in mortality rates, biomass, searching behaviour and histological properties. No direct effects were observed in the acute toxicity test (48 h) with 0.02, 0.2, 2, 10 and 20 mg l(-1) of atrazine. A chronic toxicity test (18 days) performed in six experimental channels with 15 microg l(-1) of atrazine showed significant changes in grazer behaviour, increased searching velocity and different movement patterns in animals exposed to herbicide. No significant effects were observed in rates of mortality and biomass. Kidney cells of Physa acuta displayed an important cell lysis when animals were exposed to 0.1 mg l(-1) of atrazine for 10 days, and this effect was not reversed after a decontamination process. These results provide evidence of behavioural and structural changes in freshwater molluscs due to a subacute atrazine concentration.

Animals↗

[Monitoring of vancomycin plasma levels in patients undergoing hemodialysis].

OBJECTIVE: The aim of this study was to confirm whether patients undergoing dialysis and treated with vancomycin 1 g/week or 500 mg/48 hours reach optimum plasma levels (10-25 mcg/ml). METHOD: Thirty two patients were included with a total number of 34 infectious events. The most commonly used dose was 1 g/week (67.6% of infectious events), versus 500 mg/48 hours (32.4%). Low ultrafiltration membranes were used more frequently (64.7%) than high ultrafiltration membranes (35.3%).Vancomycin was infused over an one-hour period during the last hour of the hemodialysis session and plasma samples were drawn prior to the beginning of the session. Samples were analyzed using fluorescent polarization immunoassays. RESULTS: Mean concentration results for the total population did not reach optimum values (10-25 mg/ml). In the group receiving 500 mg/48 hours, optimum mean values were not reached in any of the determinations, whereas in the group receiving 1 g/week, optimum values were reached in the fourth determination. Mean plasma levels of the antibiotic were below optimum values, regardless the type of membrane used, either low or high ultrafiltration. CONCLUSIONS: Based on the above results, we recommend titration of the vancomycin dose in this group of patients and the administration of a loading dose of 20 mg/kg during the last hour of the hemodialysis session, followed by a maintenance dose of 7 mg/kg after each session, as well as the monitoring of the drug levels in this group of patients.

Aged↗

Home training experience in peritoneal dialysis patients.

The objective of nursing is to increase health and well being, prevent morbidity and obtain the best physical and social rehabilitation. The nurse's role in Peritoneal Dialysis (PD) consists of promoting and supporting patients to perform self-care. In the'Text Book of Peritoneal Dialysis, published in 2000,the chapter dedicated to the nurses' role says:"Regular home visits are an important part of follow-up care, as the family and patient need to realize that continuing support is available... It is advisable that the first exchange after discharge from hospital is in the presence of a nurse... Early recognition and management of problems will assist in keeping the patient healthy and well rehabilitated, and will hopefully reduce hospital visits and inpatient stays" (1). Home care in Hospital Universitario La Paz has been developed with varying dedication over the years. Firstly, it was offered if significant problems appeared (1979-1990), later, home visits were started for some new PD patients (1990-1994) and follow up visits then ensued (1995-1996). In 1997, a project was undertaken which included home training for the first time in our unit, as well as periodic follow up visits. This project was shown to the Hospital Nurse Direction, and approved immediately. It started during the first term of 1997. There were several reasons which led us to undertake this project including the importance of providing PD at home and making it lifelong and it was felt that the hospital was an unfriendly environment in which to learn PD. The main objective was to establish early on, the patient's social environment and psychological status, and to assess how these influenced aspects of learning and adapting to PD. Most patients expressed a very good opinion about the home training. Only one patient rejected the presence of the nurse at home. The nursing team was very satisfied because early knowledge about the patient's psychosocial conditions and family environment was established. The incidence of peritonitis decreased.

Adult↗

[Subcostal, 3-4 cm, mini-cholecystectomy. A 3-year follow-up].

The authors report the results of mini-cholecystectomy performed through a 3 to 4 cm long subcostal incision in 29 patients with the diagnosis of acute or chronic cholecystitis, from February 1991 to November 1922. Some of the patients were obese, diabetics or presented as emergency cases. The patients were operated on in the morning, as in laparoscopic cholecystectomy, began oral intake in the afternoon and were discharged on the day after surgery. Dissection of the gallbladder was facilitated by the use of a modified gynecologic valve and long thin instruments. Duration of surgery varied from 40 to 140 minutes. Patients could return to work on the third day after surgery. Notably, the costs/benefits were on the third more favorable than those of laparoscopic cholecystectomy.

Acute Disease↗

[Environmental exposure factors and the concentrations of blood lead in Mexico City children].

Risk factors that contribute to high blood lead concentrations were determined in 113 infants, aged 3 to 7 years old, that attended pediatric consultation at the American British Cowdray Hospital (ABC) from May 1991 to October 1992. The range of blood lead concentrations was 4 to 45 micrograms/dl, with an average value of 15.6 micrograms/dl (DE = 7.0), and a geometric mean of 14.2 micrograms/dl (IC 95% = 11.9-16.5). Seventy six percent of the children presented blood lead concentrations of over 10 micrograms/dl. The main predictors of blood lead levels were the use of glazed pottery for cooking rice (ANOVA, p = 0.0000) and the storage of food in glazed pottery (t-test, p = 0.005). There was a significant association between the use of glazed pottery for cooking rice and blood lead concentrations (tendency p = 0.000). The attributable risk of this population due to the use of glazed pottery was 81 per cent. This study sustains the need to develop and enforce public health policies for programs of lead poisoning prevention.

Adolescent↗

A randomized study comparing deflazacort and prednisone in heart transplant patients.

Prednisone is widely used by most heart transplantation units despite its frequent side effects. Deflazacort, an oral synthetic steroid with fewer side effects, has been successfully used in patients after heart transplantation, but a prospective study comparing deflazacort and prednisone in transplant patients is lacking. We have carried out, in the last year, a prospective trial of deflazacort versus prednisone involving 35 consecutive heart transplant patients. Two of these patients died perioperatively (surgical mortality, 5.7%), and another two were excluded from the protocol because of diabetes mellitus in one patient and active infection before transplantation in the other patient. Thus 31 patients were enrolled in the 3-month study. All of them were treated with antithymocyte globulin, 10 mg/kg/day for 3 days after transplantation, azathioprine, and cyclosporine; patients were randomly assigned groups: 15 patients to receive deflazacort therapy, 1.5 mg/kg/day, and 16 patients to receive prednisone therapy, 1 mg/kg/day, starting the first day after transplantation. Steroids were rapidly tapered, reaching the maintenance dose at 2 to 3 weeks after transplantation (prednisone, 0.15 mg/kg/day; deflazacort, 0.25 mg/kg/day). Both groups were similar in terms of age, gender, ABO identity, serum cyclosporine levels, azathioprine dosage, and pretransplantation serum glucose and lipids levels. Seven endomyocardial biopsies were performed on each patient, at 1, 2, 3, 5, 7, 10, and 13 weeks after transplantation. Incidence of acute rejection was similar between prednisone and deflazacort groups; 33% of patients receiving prednisone therapy and 42% of patients receiving deflazacort therapy had one episode of 3A or higher rejection (not significant).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗