Consultation-liaison psychiatry in Panama.
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Biomedical subjects
Publications and source records attributed to J Arroyo.
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The highly specific alpha 2-adrenoceptor antagonist 3H-yohimbine was used to label in guinea-pig kidney and calf cerebral cortex membranes alpha 2-adrenoceptors. In both tissues binding was saturable, of high affinity (KD = 3-5 nM), rapid and readily reversible. alpha-Adrenergic antagonists inhibited binding with rank order of potency: rauwolscine greater than or equal to yohimbine greater than phentolamine much greater than prazosin greater than or equal to corynanthine, which is the typical one for alpha 2-adrenoceptors. Displacement curves of alpha-adrenergic agonists (clonidine greater than guanfacine greater than adrenaline greater than or equal to noradrenaline) were in the absence of GTP shallow with pseudo-Hill coefficients (nH) significantly less than 1.0. In the presence of GTP (10(-4) M) the curves were shifted to the right to lower affinities. However, only in guinea-pig kidney membranes nH increased up to 1.0, while in calf cerebral cortex membranes nH was not significantly influenced by GTP. The properties of alpha 2-adrenoceptors--as assessed by 3H-yohimbine binding--in guinea-pig kidney and calf cerebral cortex are, therefore, very similar to those recently determined under identical experimental conditions in human platelet membranes (Brodde et al., 1982). Although some tissue and/or species differences exist--especially the 5-6 times higher affinity of prazosin at renal and brain than at platelet alpha 2-adrenoceptors--it is concluded that alterations of human platelet alpha 2-adrenoceptors under various (patho) physiological conditions can be taken as representative for changes of other peripheral and/or central alpha 2-adrenoceptors.
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Suboptimal doses of amphotericin B in combination with either rifampin or 5-fluorocytosine were better than single-drug therapy in the treatment of disseminated Aspergillus fumigatus infection in mice. Despite the increased effectiveness of combination therapy, none of the therapeutic regimens we used completely eradicated infections in the mice when evaluated by mycological culture, even in long-term survivors.
A patient with Mycobacterium chelonei infection was treated with erythromycin stearate and streptomycin. The choice of antibiotics was based on a rapid radiometric susceptibility test developed in our laboratory.
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When measuring intra-uterine pressure, the tracing baseline varies according to maternal position because of changes in hydrostatic pressure. To compensate for this effect, the membrane of the transducer should always be kept close to the uterine fundus. An additional advantage of this method is that it enables the use of a short catheter, thus causing less tracing artifacts.
The aim of this paper has been to compare the uterine contractility, pain produced by contractions and comfort of the patients between standing and supine position. The study has been performed in twenty normal nulliparae who were changed from supine to standing position and viceversa at intervals of approximately thirty minutes. Intrauterine pressure and fetal heart rate were continuously monitored. Cervial dilatation was evaluated every thirty minutes. No medication was given to the patients. They were asked to assess the pain produced by uterine contractions in each one of both positions and which was the more comfortable. It has been found: 1. That the intensity of contractions was significantly higher in fifteen out of the twenty patients in standing position. 2. Frequency of contractions diminished significantly in one third of the patients. 3. Uterine activity increased significantly in half of them. 4. Consistently, less pain accompanied uterine contractions in standing position. 5. Patients reported more comfort in this position. The average duration of labor was 3 hrs 55 min. This duration is short, compared with standard clinical experience and with published data. No complications occurred, by the use of standing position during labor, on the mother or fetus. The physiological mechanisms responsible for the above mentioned effects of standing position are unknown. It is condluced that there are no clear arguments against the use of standing position during labor and that this position should be used more frequently in clinical obstetrics, provided obstetrical conditions are similar to those reported in this paper.
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Three cases of sternocostoclavicular hyperostosis (SCCHO) or pustulotic arthro-osteitis (PAO) associated with plantar pustulosis are presented. Two of them were associated with psoriasis vulgaris although the pustulosis was of a different histological type in each case. Anatomo-pathological study of two of these three cases shows that this hyperostosis is secondary to an inflammatory osteomedulloperiosteal remodelling suggesting an infectious origin which remains to be proven. The relationship of this syndrome with some seronegative spondylarthropathies cannot, however, be excluded.
We report seven cases of congenital absence of the lacrimal puncta, a condition that may be either an isolated finding or associated with other developmental anomalies. General pediatric evaluation of two patients with punctal agenesis revealed no additional abnormalities; these cases were managed by probing and silicone intubation. The other five cases were associated with other significant, clinically obvious abnormalities; several of these patients required more aggressive management of their lacrimal disorders, including dacryocystorhinostomy and conjunctivo-dacryocystorhinostomy. Previous reports support the impression generated by this series that otherwise normal appearing children with congenital absence of the lacrimal puncta do not require an extensive work-up. Probably many children with absent puncta are asymptomatic and remain undiagnosed.