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Biomedical subjects

J Arana

Publications and source records attributed to J Arana.

At least 19 recordsLinked to original sources
PubMed2001

Anorectal atresia. An experimental model in the rat.

Aiming to assess the development of the anorectal sphincteric apparatus and whether it is influenced by the presence of an intestinal conduit through the muscular complex, we seek to develop an experimental model of anorectal atresia in foetuses of female pregnant rats, given orally the herbicide ethylenethiourea (ETU). Six 3-months-old, 300 g female Wistar rats were included in the study group (SG). The foetuses of another unexposed rat formed the control group (CG). In the SG 54, foetuses were alive, all had hypoplasia of the tail and 47 (87%) had no visible anal orifice. The 18 foetuses of the CG were normal. The histological study was performed at the level of the pubic symphysis. Type I anorectal atresia was defined when this section demonstrated an intestinal conduit and Type II when only a muscular cord was found, without any intestinal tube. This study was completed in 15 (32%) of the SG, 9 (60%) with anorectal atresia Type II and 6 (40%) with atresia Type I, and in 11 animals (61%) of the CG. The thickness of the sphincter muscle was larger in the CG (260.47+/-35.32 micro) than in the SG (208.98+/-55.01 micro), p<0.05, but this difference was due to the animals showing atresia Type II. To conclude: ETU had a teratogenic effect. The foetuses with atresia, particularly Type II, had a decreased development of the muscular complex. The presence of an intestinal conduit does not significantly influence the development of the muscular complex.

Anal Canal↗
PubMed2000

The photocatalytic disinfection of urban waste waters.

In this paper we present the results of the photocatalytic disinfection of urban waste water. Two microbial groups, total coliforms and Streptococcus faecalis, have been used as indexes to test disinfection efficiencies. Different experimental parameters have been checked, such as the effect of TiO2, solar or UV-lamp light and pH. Disinfection of water samples has been achieved employing both UV-lamp and solar light in agreement with data shown by other authors. The higher disinfection rates obtained employing an UV-lamp may be explained by the stronger incident light intensity. Nevertheless no consistent differences have been found between TiO2-photocatalysis and direct solar or UV-lamp light irradiation at natural sample pH (7.8). At pH 5 the presence of TiO2 increases the relative inactivation rate compared with the absence of the catalyst. After the photocatalytic bacterial inactivation, the later bacterial reappearance was checked for total coliforms at natural pH and pH 5, with and without TiO2. Two h after the photocatalytic treatment, CFU increment was almost nill. But 24 and 48 h later an important bacterial CFU increment was observed. This CFU increment is slower after irradiation with TiO2 at pH 5 in non-air-purged samples.

Catalysis↗
PubMed2000

Ocular involvement in systemic toxoplasmosis: a case report.

We report a case of adult acquired toxoplasmosis with ocular involvement in a 29 year old immunocompetent female. The patient had an illness for approximately 3 weeks characterized by lymphadenopathy, malaise and rash that was diagnosed serologically as toxoplasmosis. At the time of diagnosis, she developed signs and symptoms of retino choroiditis. She had serologic evidence of cytomegalovirus (CMV) infection as well as the recent toxoplasma infection. The patient was treated with pyrimethanime, sulfadiazone and folic acid for 6 weeks, plus prednisone for 4 weeks, during which the illness resolved. Toxoplasmosis is a protozoan infection that occurs worldwide, and is the most common cause of infectious retinochoroiditis in otherwise healthy individuals. Most cases of Toxoplasma infection in the immunocompetent adult are asymptomatic. The most common clinical presentation is localized lymphadenopathy. Ocular signs, which are common in congenitally acquired toxoplasmosis, may rarely be the only manifestation of acquired systemic toxoplasmosis. It has been suggested that concomitant infection with a DNA virus, such as CMV or herpes simplex virus, may facilitate the penetration of protozoa into cells, or that antigenic stimulation from toxoplasma antigens may activate endogenous latent CMV in the recipient. The occurrence of ocular involvement during toxoplasmosis and its association with a DNA virus is reviewed.

Adult↗
PubMed1998

Prognosis of patients with a first episode of sustained monomorphic ventricular tachycardia.

AIMS: To evaluate the cardiac mortality in patients suffering from a first episode of sustained monomorphic ventricular tachycardia (SMVT). METHODS: 100 patients less than 75 years old were evaluated during a 50-month follow-up period. Patients were classified into four groups: myocardial infarction, dilated cardiomyopathy, normal heart and miscellany. Seventeen patients underwent a cardioverter-defibrillator implantation, two heart transplant, three aneurysmectomy and 10 other types of cardiac surgical proceedings. RESULTS: Patients with a left ventricle ejection fraction (EF)> or =50% presented a cardiac mortality of 5% compared with 38% of those with EF<50%. Etiology of underlying cardiomyopathy with an EF> or =50% was associated with a cardiac mortality of 5% (normal heart), 5% (myocardial infarction) and 9% (miscellany) compared to those with EF<50%: 33% (dilated cardiomyopathy) and 40% (myocardial infarction). Patients who experienced syncope during the first episode of SMVT showed a cardiac mortality of 31% compared to those 14% (P < 0.05) who did not experience. Patients with syncope, myocardial infarction and EF<50% showed a cardiac mortality of 68%. CONCLUSION: The present study shows that survival after the first episode of SMVT is closely related to EF and the existence of syncope. Patients with myocardial infarction and EF<50% had a worse prognosis when the site was the inferior wall.

Aged↗
PubMed1998

Esophageal function in achalasia: preoperative and postoperative manometric studies.

BACKGROUND/PURPOSE: Aperistalsis observed in children with achalasia may be secondary to sphincteric spasm or reflect a primary esophageal dysfunction. The aim of this study was to assess manometrically sphincteric function and esophageal motility before and after successful myotomy. METHODS: Conventional stationary and pull-through manometry were performed preoperatively in 14 patients and postoperatively in 13. Ambulatory 24-hour manometry was carried out in four and eight patients in these two groups, respectively, and the results were compared with those of 23 refluxing youngsters. RESULTS: Sphincter hypertony with lack or incompleteness of relaxation was found preoperatively in all patients, and sphincter pressure decreased dramatically after myotomy in all of them. All patients had aperistalsis preoperatively, and only a few had some primary, but weak, contractions postoperatively. Ambulatory manometry results confirmed a reduced number of motor events even during meals and only insignificant improvement of progressiveness, completeness and amplitude of waves after myotomy irrespective of the time elapsed since the procedure, the degree of recovery of esophageal caliber, and the clinical outcome. CONCLUSIONS: Motor disorders in achalasia in children are similar to those of adults with the same disease. Motor recovery is observed only in some patients, although it is never complete, and their esophagi will remain ineffective for life. Because myotomy destroys the sphincter, and motility is permanently impaired in this condition, a fundoplication must be interposed to allow long-term mucosal protection.

Adolescent↗
PubMed1996

[Intestinal autograft: creation of an isolated intestinal segment by entero-enteropexy].

An isolated bowell segment (IBS) was created in rats by a two-stage procedure. Initial lateral entero-enteropexy between small and colonic bowell was performed. Six weeks later, the small bowell mesentery was divided. After four weeks, the survival animals were killed, the viability of the segment is maintained by developing vascular collateral across the coaptation between both intestinal segments, under light microscopy the willi were atrophied on 50% of animals.

Animals↗
PubMed1996

[Syncope associated with glossopharyngeal neuralgia and parapharyngeal tumor].

The reflex-induced cardiovascular syncope is rarely associated with facial neuralgia and neck neoplasms. We report the case of a male with vasopressor and cardioinhibitor syncopes, despite the implantation of a pacemaker. Because of a glossopharyngeal neuralgia, a neoplasm of the left parapharyngeal fossae is diagnosed. The pathophysiology and the therapeutic approach is discussed.

Aged↗
PubMed1995

Gastroesophageal reflux in association with the Sandifer syndrome.

Eight children presenting with the Sandifer syndrome (with neck contorsion, radiologic studies of the cervical spine and normal neurologic exploration) have been studied in relation to gastro-esophageal reflux (GER). In the eight cases barium swallow, 24 h pH-metering, manometry, endoscopy and biopsy were made, presenting pathological GER. The barium swallow was pathologic in 62% of them. The pH-metering in 37%. The lower esophageal sphincter pressures were decreased in 37%, with esophageal motility alteration in 75%. Signs of macro and/or microscopic esophagitis were found in 62%. Three patients received surgical treatment and the rest medical treatment, with improvement of the neck contorsion in all cases. We have attempted to evaluate which one of the functional explorations for the GER diagnosis is better in this kind of patients, and we have demonstrated that the most frequently found alteration is the esophageal dysmotility.

Barium Sulfate↗
PubMed1994

[Massive fecal impaction in a patient with osteogenesis imperfecta].

The case of a 22 year old male with massive faecal impaction and anorectal mechanical stenosis caused by multiples bone fractures and pelvic deformities secondary to imperfect osteogenesis is reported. The patient was treated with subtotal colectomy and permanent colostomy.

Adult↗
PubMed1993

[The limits of the Nutrition Committee in applying parenteral nutrition].

In order to assess the benefits of a Nutritional Team in our hospital, the Nutritional Committee made a prospective study concerning the Parenteral Nutrition application between June 8th and July 23rd 1992. We studied 94 patients, mean age 51.5 (0-88). They had 918 nutritional units (20 NU/day) for a mean time of 13.2 days. The main nutritional indication was intestinal pathology (47.9% onco-surgical patients). A Parenteral Nutrition standard type was usually given to patients through a Drum type catheter. Infectious complications reached a 38.5% (13.8% thrombophlebitis). We have performed analytical controls in 83.7% patients, 83.6% of them had pathologic results. The percentage was of deaths 7.5%. After these results, we conclude that there is a need for a specifically trained medical group taking care of the nutritional management of the patients. Thus, we could assure the quality of nutritional therapy.

Adolescent↗
PubMed1993

[Helicobacter pylori infection and duodeno-gastric reflux].

We have studied and measured the duodenogastric reflux in 11 children with chronic abdominal pain and Helicobacter pylori (HP) through 24-hours gastric pH-metric studies. All parameters evaluated: Number of reflux episodes (NR 92.87 +/- 27.66), number of reflux episodes longer than 5.0 minutes (NR > 5M 11.45 +/- 4.68), longest reflux episode (LR 67.37 +/- 45.57) and alkaline reflux area (AA 604.89 +/- 443.54) had significative differences against a normal group (40 children). We concluded that duodenogastric reflux and HP are frequent together.

Adolescent↗
PubMed1991

Surgery for gastroesophageal reflux in children with normal pH studies.

Esophageal pH monitoring is recognized as the best diagnostic procedure for gastroesophageal reflux (GER) and operation is seldom recommended in the absence of abnormal pH data. To emphasize that operation should not be ruled out for children who may have false-negative pH studies, we report 14 patients operated on for GER in spite of normal pH-monitoring. The mean age was 54 months (range, 18 to 90). Clinical features included vomiting, dysphagia, respiratory disease, anemia, and torticollis. All had radiologic evidence of GER, and 10 had endoscopic and histological esophagitis. Conventional pH-monitoring values were normal but lower esophageal sphincter pressure and propulsive peristalsis were significantly decreased whereas nonpropulsive contractions were predominant. Operation was recommended after an average of 24 months of unsuccessful medical treatment. Independent postoperative assessment showed that 13 of the 14 patients were relieved of their symptoms and dysphagia persists in one. We suggest that the diagnosis of GER should be accepted on the basis of sound clinical judgement plus more than one abnormal test even when pH results are normal. Operation should not be withheld when clinically indicated. There are several explanations for false-negative pH studies, of which alkaline reflux is probably the most important and warrants further investigation in children.

Child, Preschool↗
PubMed1990

[Acidic stimulation of esophageal peristalsis: its prognostic value in reflux].

Gastroesophageal Reflux (GER) in children manifests itself by several clinical pictures. Its diagnosis is difficult and so are surgical indications. The search for prognostic parameters able to predict the need for surgery are therefore warranted. We have demonstrated in previous studies in children with GER a decrease in propulsive peristalsis and an increase in non-propulsive activity. We have also reported that patients able to respond to medical treatment correct their motor trouble when acid is instilled into the esophagus, whereas those unable to respond to it do not. Aiming at clarifying the prognostic value of this acid challenge test we have thus measured Esophageal Motor Efficiency (EME) (prop. waves/h multiplied by mean pressure) in basal conditions and after acid challenge in 52 children divided into two groups according to their response to medical treatment during periods exceeding 6 months. EME in basal conditions did not allow differentiation between both groups, but EME after acid challenge did so. Optimum threshold value was 565, sensitivity 0.76, specificity 0.75, positive predictive value 87%, and negative predictive value 60%. This test seems to have some prognostic value in pediatric GER.

Child↗
PubMed1989

Motor efficiency of the refluxing esophagus in basal conditions and after acid challenge.

We have investigated manometrically and endoscopically 60 children with extended pH metering-documented gastroesophageal reflux (GER) and a control group of 14 children of comparable ages. In an attempt to simplify the evaluation of esophageal peristalsis, we measured the frequency of propulsive waves (in waves/hour) and their mean pressure (in mm Hg) in the body of the esophagus and multiplied both values to result in one single figure that reflected esophageal motor efficiency (EME) in some way. We performed the tests in basal conditions (EMEB) and after instillation of 5 mL of 0.1 N CIH into the esophageal lumen (EMECIH). In comparison with controls, refluxing children had a lower sphincter pressure (LESP) (14.9 +/- 8 v 11.8 +/- 6.9 mm Hg, P less than 0.05), an increased proportion of nonpropulsive waves (38.8 +/- 29.3% v 68 +/- 27%, P less than 0.001), and a significantly lower EMEB (896.6 +/- 777 v 375 +/- 306, P less than 0.001). These results suggest that both the sphincteric antireflux barrier and esophageal pump can be damaged in GER. There was a weak, but significant, correlation between EMEB and esophagitis grade (rs = -.25, P less than 0.05). Furthermore, esophageal motor response after CIH instillation may have some prognostic value because EMECIH was significantly higher in those of the 52 children followed-up for more than a year who responded to medical treatment (n = 16) than in those in whom medical treatment was a failure (n = 36) (981.2 +/- 617.4 v 460.5 +/- 452.3, P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗
PubMed1989

[Peristalsis induced in normal esophagus and gastroesophageal reflux].

We have investigated manometrically wether esophageal motor response (in terms of frequency and mean pressure of propulsive and non-propulsive waves) to the instillation of saline and 0.1 N HCl into the lumen was different in normal (n = 18) and refluxing (n = 66) patients. Instillation of saline induced bursts of non-propulsive waves both in normal and refluxing patients. Additionally, it induced in the latter an increase in propulsive waves. Instillation of acid did not induce in normal subjects changes different from those generated by saline but stimulated considerably the refluxing esophagus which responded with an increased number of more powerful waves. This results suggest that refluxing esophagus is hypocontractile as compared with the healthy one and that it is awaken by acid as if it tried to improve its motor efficiency.

Adolescent↗
PubMed1987

[The average duration of nocturnal reflux in the prognosis of respiratory problems associated with gastroesophageal reflux].

Choice of therapeutic approach remains difficult in patients with gastro-oesophageal reflux and respiratory symptoms. Except in children in whom microaspiration has been demonstrated it is very difficult to predict which ones are going to be relieved from their respiratory disease after GER treatment. In 1981 Jolley and coll. found that the mean duration of nocturnal episodes of reflux (MDNR) in extended pH-metering excluding post-cibal hours could differentiate not only patients with and without respiratory manifestations, but also those in whom respiratory tract disease will disappear after GER treatment from those in whom this will be useless. Only some references on this topic have been published ever since. We have reviewed the charts and pH tracings of the 70 patients with respiratory disease and GER treated in our service aiming at assessing the real value of this parameter in our hands. Fifty-two cases could be evaluated: 41/52 were either improved or completely relieved from their respiratory manifestations (79%) where has the remaining 21% were unchanged by GER treatment. In the first group MDNR was 13.1 +/- 9.7 min and in the second one it was 6.3 +/- 4.6 (p less than 0.05). Our results confirm that MDNR is a valid parameter in order to make prognosis in this particular group of patients.

Child↗
PubMed1987

[Results of surgical treatment of gastroesophageal reflux with respiratory manifestations].

Respiratory tract disease was the main indication for surgery in 45 out of the 102 children operated upon for GER in the last 7 years: twenty-four had recurrent bronchitis and pneumonia, 18 had bronchitis with constriction (true asthma in 10), 2 had unbearable cough and 1 apnoeic crises. All had been medically treated before without success. The diagnosis of GER has been accepted only in patients with abnormal results in three or more of the following tests: barium swallow, extended pH-metering, manometry, endoscopy-biopsy and gastro-oesophageal scintigraphy. Nissen fundoplication cured GER in all cases, and its effect on respiratory tract disease after an average follow-up of 17 months (range 6 to 48) was rather encouraging: twenty-six children cured (57%), 9 improved (21%) and 10 remained unchanged (22%). Failures were more frequent in children with bronchoconstriction (45%) and in those without prior digestive symptoms (36%). Surgery is probably indicated more often in the treatment of respiratory tract diseases associated with GER in children than it was previously thought, but indications remain difficult and the results are uncertain in children with either asthma or bronchoconstriction.

Child↗