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J Barrio

Publications and source records attributed to J Barrio.

At least 19 recordsLinked to original sources
PubMed2006

In vitro tracheal hyperresponsiveness to muscarinic receptor stimulation by carbachol in a rat model of bleomycin-induced pulmonary fibrosis.

1 Bleomycin-induced lung injury is widely used as an experimental model to investigate the pathophysiology of pulmonary fibrosis but the alterations in the pharmacological responsiveness of airways isolated from bleomycin-exposed animals has been scarcely investigated. The aim of this study was to examine the in vitro tracheal responses to muscarinic receptor stimulation with carbachol in a rat bleomycin model. 2 Concentration-response curves to carbachol (10 nm to 0.1 mm) were obtained in tracheal rings isolated from Sprague-Dawley rats 14 days after endotracheal bleomycin or saline. The intracellular calcium signal in response to carbachol (10 microm) was measured by epifluorescence microscopy using fura-2 in primary cultures of tracheal smooth muscle cells from bleomycin- and saline-exposed rats. Circulating plasma tumour necrosis factor (TNF)-alpha/interleukin (IL)-1beta levels were measured by enzyme-linked immunosorbent assay. 3 Maximal contraction in response to carbachol was significantly greater in tracheal rings from bleomycin-exposed rats compared with controls (15.8 +/- 1.3 mN vs. 11.8 +/- 1.4 mN; n = 19, P < 0.05). 4 Carbachol (10 microm) elicited a transient increase of intracellular calcium with greater increment in tracheal smooth muscle cells from bleomycin-exposed rats compared with controls (372 +/- 42 nmvs. 176 +/- 20 nm; n = 7, P < 0.01). 5 Circulating plasma levels of TNF-alpha/IL-1beta were augmented in bleomycin-exposed rats compared with controls. Tissue incubation with TNF-alpha (100 ng ml(-1))/IL-1beta (10 ng ml(-1)) increased in vitro tracheal responsiveness to carbachol. 6 In conclusion, tracheal contraction in response to muscarinic receptor stimulation with carbachol was increased in bleomycin-exposed rats. This in vitro cholinergic hyperresponsiveness may be related to the augmented levels of inflammatory cytokines in bleomycin-exposed rats.

Animals↗
PubMed2006

[Clinical effect of mivacurium in morbidly obese patients].

OBJECTIVES: To compare the clinical effect of mivacurium in morbidly obese and normal-weight patients. PATIENTS AND METHODS: Ten morbidly obese patients (body mass index >40) and 10 normal-weight patients (body mass index, 21-24) with normal plasma cholinesterase levels. Anesthesia was provided with propofol and remifentanil in continuous infusion and a mixture of oxygen and nitrous oxide. Mivacurium was administered at a dose based on the patient's weight (0.15 mg x kg(-1)). The neuromuscular block was monitored by train-of-four (TOF) acceleromyography after stimulation of the cubital nerve at the forearm. We measured the onset time (time from administration of the muscle relaxant to 95% twitch depression), duration of block (times from dosing to 5% recovery after the first twitch [T1] of a TOF stimulus and to a TOF ratio of 80%), and the recovery indices (time between 25% and 75% recovery after T1 and between recovery of TOF ratios of 25% and 80%). Groups were compared with the Student t test. RESULTS: Mean (SD) onset time was similar in the 2 groups (normal weight 2.73 [1] minutes vs morbidly obese 1.91 [0.6] minutes). Other measures of duration and recovery were also similar in the 2 groups, respectively: duration of dose-T1 5%, 12.23 (2.1) vs 11.45 (3) minutes; dose-TOF ratio 80%, 24.71 (4.6) vs 24.81 (5) minutes); recovery index T1 25%-75%, 6.45 (2) vs 5.56 (1) minutes; recovery of TOF ratio T1 25%-80%, 9 (2) vs 10.11 (2) minutes. CONCLUSION: We found no differences in the clinical effect of mivacurium between morbidly obese and normal-weight patients when doses were based on real weight.

Adult↗
PubMed2005

Time course and train-of-four fade of mivacurium block during sevoflurane and intravenous anaesthesia.

BACKGROUND AND OBJECTIVE: Volatile anaesthetics inhibit nicotinic acetylcholine receptors at clinically relevant concentrations with higher affinity for the neuronal nicotinic receptor. The inhibitory effects of propofol on nicotinic receptors have only been documented at supraclinical concentrations. The aim of this study was to determine recovery properties and train-of-four (TOF) fade of mivacurium during sevoflurane and propofol anaesthesia, in order to examine any differences both in the enhancement of the neuromuscular block (postjunctional effects) and in TOF fade (prejunctional effects). METHODS: Twenty ASA I-II adult patients were randomly allocated to maintenance of anaesthesia with sevoflurane (end-tidal concentration 2%) or propofol. Neuromuscular block was assessed by acceleromyography and a single dose of mivacurium (0.15 mg kg(-1)) was administered (in the sevoflurane group after 30 min of exposure to sevoflurane). We measured time for recovery of the first twitch of the TOF (T1) from 25-75%, time from 25% recovery of T1 to achieving a TOF ratio (TOFR) of 0.8, TOFR at 50%, 75% and 90% recovery of T1, and height of T1 at TOFR of 0.7 and 0.9. Data were tested using t-test for independent samples. RESULTS: Recovery times (mean (95% confidence interval, CI)) of mivacurium in the sevoflurane group (T1 25-75%, 11.3 (8.1-14.5) min; T1 25%-TOFR0.8, 19.1 (15.7-22.5) min) were significantly longer (P < 0.05) than in the propofol group (T1 25-75%, 6.5 (5.2-7.7) min; T1 25%-TOFR0.8, 11.3 (7.8-10.3) min). No differences were found in the relations between TOFR and T1 or vice versa, between the groups. CONCLUSIONS: Recovery times after a single dose of mivacurium were prolonged by sevoflurane compared with propofol but no differences in TOF fade were observed between the two anaesthetics.

Adult↗
PubMed2003

[Leishmaniasis in a patient with liver cirrhosis].

We present a 35 years-old man with fever related leishmania infection as the first complication of a previously undiagnosed cirrhosis. Diagnosis of leishmaniasis is often complicated. Clinical and therapeutical aspects are commented.

Adult↗
PubMed2002

[Variability of the clinical expression of Ecstasy-induced hepatotoxicity].

3,4-methylenedioxymethamphetamine (MDMA) is an amphetamine derivative, known as ecstasy. Because of its euphoric effects, the use of this substance as a drug of abuse is becoming increasingly widespread. The development of hyperthermia, disseminated intravascular coagulation, rhabdomyolysis, acute renal failure, cardiac arrhythmia and neurotoxicity have been described in association with the use of this drug. Moreover, in the last few years, cases of liver involvement, associated or not with the above-mentioned entities, have been described, ranging from mild acute hepatitis to fulminant hepatic failure and death. We present four cases of ecstasy-induced hepatotoxicity. Outcome was favorable in three patients while the fourth required liver transplantation. Consequently, ecstasy ingestion should be ruled out as a cause of acute non-viral hepat

Abdominal Pain↗
PubMed2002

[Lung transplantation in patients in mechanical ventilation before transplantation].

Mechanical ventilation before lung transplantation has been identified as a risk factor for early death after surgery. However, several studies have reported patient series in which ventilation assistance was given preoperatively without increasing the rates of postoperative complications and death, apart from increasing time of postoperative intubation. The present retrospective analysis of the postoperative course of patients who had been mechanically ventilated before transplantation encompasses a period of 5 years in our hospital. Eight transplants (7 double- and 1 single-lung procedures) were performed. Six patients (75%) required extracorporeal oxygenation during surgery. Three patients (37.5%) died within 30 days of receiving the transplanted lung. The mean time of intubation after the operation was 10.3 days and the mean stay in the postoperative recovery and intensive care unit was 27.5 days. The most common postoperative complications were respiratory colonization (100%), with infection in 3 patients, and reimplantation injury (50%). Pretransplant mechanical ventilation was associated with high risk in the patient series we report; however, the survival rate observed suggest that such patients should be considered acceptable candidates to receive grafts if indicated.

Adolescent↗
PubMed2002

[Unsuspected prolonged activated partial thromboplastin time in emergency surgery. Diagnostic and therapeutic guide].

Systematic complementary testing for asymptomatic patients before surgery yields an unexpectedly high percentage of anomalous results. Such results rarely affect perioperative management of the patient but may lead to unnecessary delays, which are potentially of great importance in emergency surgery. A 55-year-old woman with a clinical diagnosis of acute appendicitis was seen to have a prolonged activated partial thromboplastin time (APTT) of 1.94 before surgery. The patient's history did not suggest a coagulation disorder was likely, and when mixing normal and problem plasma failed to correct the APTT, we suspected an unspecified circulating anticoagulant was present. Surgery was delayed no further and no measures were taken. No excessive bleeding occurred during surgery or postoperative recovery. The main possible diagnoses for a women with unforeseen prolonged APTT are the presence of an unspecified circulating anticoagulant, factor XI or factor XII deficiency, or factor VIII deficiency associated with von Willebrand disease. Focusing on detecting a coagulation disorder while taking a patient's history and performing a simple laboratory test (mixing normal and problem plasma) can be useful for orienting management in emergency surgery.

Blood Coagulation Disorders↗
PubMed2001

Sonographic findings in brucellar hepatic abscess.

Brucellar hepatic abscesses are rare; to our knowledge, only 41 cases have been described in the literature. We report the case of a 29-year-old Spanish woman who was hospitalized because of fever, weakness, and weight loss. Abdominal sonography showed a hypoechoic lesion with central calcification. Brucella spp. were not isolated from an aspirate of the liver or blood cultures. The diagnosis was based on the association of characteristic sonographic features (central calcification and peripheral necrotic areas) and positive Brucella agglutination tests. The patient improved rapidly with antibiotic treatment.

Adult↗
PubMed2001

[Diagnostic utility of hepatic hemodynamics study in hepatoportal sclerosis].

AIM: To evaluate the diagnostic utility of catheterization of the suprahepatic veins in patients with suspected non-cirrhotic portal hypertension as well as to characterize the clinical features and evolution of this process. PATIENTS AND METHODS: Hepatic hemodynamics studies, transjugular biopsy and venography were performed in seven patients with suspected non-cirrhotic portal hypertension. In all patients the combination of the three procedures gave the diagnosis of hepatoportal sclerosis, which was subsequently confirmed by direct portography and percutaneous or laparoscopic liver biopsy. RESULTS: Three patients presented esophageal variceal bleeding at diagnosis. Only one patient required intrahepatic shunting due to refractory bleeding. None of the patients required surgical shunting or presented alterations in liver function. CONCLUSIONS: Hepatic hemodynamics study with transjugular biopsy and venography is an effective procedure in the diagnosis of hepatoportal sclerosis and in most cases invasive confirmatory tests are not required. The course of the disease is relatively benign if variceal bleeding is controlled. The treatment of choice in these patients is pharmacological and endoscopic.

Adult↗
PubMed2001

[Peutz-Jeghers syndrome associated with multiple epithelial tumors].

The association between Peutz-Jeghers syndrome and multiple epithelial neoplasias is infrequent. Tumors of the gastrointestinal tract, genitals and breast are common in this syndrome and tumors of the kidney and biliary tract are exceptional. We present the case of a 68-year-old woman with Peutz-Jeghers syndrome who presented with right kidney carcinoma and numerous small, bilateral tumors of the sex cords with annular tubules of the ovary. Right nephrectomy, double annexectomy and total hysterectomy were performed. The patient died two years later following the development of rectal carcinoma diagnosed by sigmoidoscopy and biopsy and an episode of obstructive jaundice compatible with cholangiocarcinoma.

Aged↗
PubMed2001

[Krukenberg tumor secondary to gastric carcinoma in a woman in her eighth month of pregnancy].

The association of gastric cancer and pregnancy is rare. The cases reported by non-Japanese authors are unusual. Tumors tend to be in advanced stage when diagnosed since the symptoms of gastric cancer are easily presumed to be secondary to those of normal pregnancy. We report the case of a 43-year-old female with gastric carcinoma presenting as a Krukenberg's tumor in the eighth month of gestation. A healthy child was born and after delivery, partial gastrectomy was performed and adjuvant chemotherapy was administered. The patient died 12 months after diagnosis.

Adult↗
PubMed2001

[Macromolecular creatinine kinase in patients diagnosed with ulcerative colitis].

Macromolecular creatinine kinase (macro-CK) type 1 is a macroenzyme formed by the union of an immunoglobulin with a creatinine kinase (CK) enzyme. Its presence in the blood may lead to misdiagnosis of heart disease. This macromolecule has been described in various diseases and is relatively more frequent those with autoimmune etiology. We describe three cases of ulcerative colitis that presented elevated MB-isoenzyme of CK activity greater than the total CK quantified by the immunoinhibition method. Electrophoresis revealed an atypical band that corresponded with the presence of a type 1 macroenzyme. Detection of this macromolecule could be useful in cases of ulcerative colitis when results of blood testing lead to suspicion of ischemic disease.

Adult↗
PubMed2001

[Refractory hypotension sustained during general anesthesia due to chronic treatment with angiotensin-converting enzyme inhibitors].

Perioperative management of angiotensin-converting enzyme inhibitors (ACEI) is controversial because of associated hypertensive episodes during induction and maintenance of anesthesia. A 71-year-old woman with a non-functioning thyroid node was scheduled for thyroid lobectomy. Her medical history included high blood pressure and she was being chronically treated with ACEI, which were taken until the morning of surgery. After induction of anesthesia, arterial hypotension refractory to crystalloid therapy developed and worsened in spite of administration of a gelatin-type colloid (Gelafundina). The patient did not respond to ephedrine or dopamine and required stabilization with adrenalin in continuous perfusion for 12 hours. Later evolution was satisfactory and recovery took place without sequelae. We discuss the anesthetic implications of chronic ACEI treatment and possible hemodynamic repercussions of associated administration with gelatin-type solutions or human albumin.

Aged↗
PubMed2001

Prevalence of coeliac disease in unexplained chronic hypertransaminasemia.

OBJECTIVE: To determine the prevalence of coeliac disease amongst the population with unexplained chronic hypertransaminasemia in our region. PATIENTS AND METHODS: A prospective study was carried out on 147 consecutive patients with chronic hypertransaminasemia, having previously discarded alcoholic cause, hepatotoxic drugs, B, C and Delta viral infections, autoimmune hepatitis, primary biliary cirrhosis, Jemochromatosis, alfal-antitrypsin deficiency, Wilson's disease, congestive liver and illicit drug use. Serum Ig A to gliadin and endomysium antibodies were determined. Intestinal biopsy was carried out in cases those positive for one or both antibodies. RESULTS: One patient was positive for both IgA to gliadin and to endonisyum antibodies, whereas another three patients were positive to IgA to gliadin only. A duodenal biopsy proved normal in two, a total villous atrophy in one and subtotal atrophy in other. CONCLUSIONS: 1. The prevalence of coeliac disease amongst the population with unexplained chronic hypertransaminasemia in our region is 1.4%. 2. In our region, screening for coeliac disease in unexplained chronic hypransaminasemia should take a secondary place.

Adolescent↗