Biomedical subjects

J C Elvira

Publications and source records attributed to J C Elvira.

5 recordsLinked to original sources

PubMed1999

Induced endothelial cell loss in phacoemulsification using topical anesthesia plus intracameral lidocaine.

PURPOSE: To determine whether lidocaine 1% injected into the anterior chamber during phacoemulsification damaged the corneal endothelium. SETTING: Ophthalmology Service, University Hospital, San Juan de Alicante, Spain. METHODS: In 19 eyes of 19 patients, small incision phacoemulsification and foldable lens (AcrySof MA60BM) implantation was performed using topical anesthesia supplemented by lidocaine 1% (0.3 mL) in the anterior chamber. All cases were operated by the same surgeon. Specular microscopy was performed before surgery and 1 and 3 months postoperatively. RESULTS: Mean endothelial cell loss was 5.41% +/- 8.50 (SD) at 1 month and 5.93 +/- 8.50% at 3 months. CONCLUSIONS: The endothelial damage was similar to that described by other authors, suggesting that phacoemulsification surgery can be performed successfully using topical anesthesia supplemented by lidocaine 1% in the anterior chamber.

Aged↗

PubMed1999

The importance of physical fitness in the performance of adequate cardiopulmonary resuscitation.

The aim of the present investigation was to evaluate the influence of the physical fitness of a cardiopulmonary resuscitation (CPR) provider on the performance of and physiologic response to CPR. To this end, comparisons were made of sedentary and physically active subjects in terms of CPR performance and physiologic variables. Two study groups were established: group P (n=14), composed of sedentary, professional CPR rescuers (mean [+/-SD]; age, 34+/-6 years; VO2max, 32.5+/-5.5 mL/kg/min), and group Ex (n=14), composed of physically active, nonexperienced subjects (age, 34+/-6 years; VO2max, 44.5+/-8.5 mL/kg/min). Each subject was required to perform an 18-min CPR session, which involved manual external cardiac compressions (ECCs) on an electronic teaching mannequin following accepted standard CPR guidelines. Subjects' gas exchange parameters and heart rates (HRs) were monitored throughout the trial. Variables indicating the adequacy of the ECCs (ECC depth and the percentage of incorrect compressions and hand placements) also were determined. Overall CPR performance was similar in both groups. The indicators of ECC adequacy fell within accepted limits (ie, an ECC depth between 38 and 51 mm). However, fatigue prevented four subjects from group P from completing the trial. In contrast, the physiologic responses to CPR differed between groups. The indicators of the intensity of effort during the trial, such as HR or percentage of maximum oxygen uptake (VO2max) were higher in group P subjects than group Ex subjects, respectively (HRs at the end of the trial, 139+/-22 vs 115+/-17 beats/min, p < 0.01; percentage of VO2max after 12 min of CPR, 46.7+/-9.7% vs 37.2+/-10.4%, p < 0.05). These results suggest that a certain level of physical fitness may be beneficial to CPR providers to ensure the adequacy of chest compressions performed during relatively long periods of cardiac arrest.

Adult↗

PubMed1998

Active compression-decompression cardiopulmonary resuscitation in standing position over the patient (ACD-S), kneeling beside the patient (ACD-B), and standard CPR: comparison of physiological and efficacy parameters.

The purpose of this investigation was to compare the efficacy of three different cardiopulmonary resuscitation techniques: (a) standard cardiopulmonary resuscitation (CPR), (b) active compression-decompression cardiopulmonary resuscitation (ACD-CPR) with the rescuer standing beside the patient (ACD-B), and (c) ACD-CPR with the rescuer in a standing position over the patient (ACD-S). The physiological responses of the rescuers when performing these techniques were also evaluated. A total of 14 experienced professional rescuers of a mobile intensive care unit (32+/-6 years), participated in this investigation. On 3 different days (randomised order), each of them performed on a manikin (a) CPR, (b) ACD-B, and (c) ACD-S. Parameters indicative of both CPR performance (time to exhaustion, compression depth and efficacy), and rescuers' physiological responses (blood lactate; minute ventilation (VE); heart rate (HR); oxygen uptake VO2; respiratory exchange rate (RER); and percentage of VO2max) were monitored during the trials. The main findings of this investigation were: (a) the evidence of a greater physiological load for the rescuers during the ACD-CPR techniques compared to CPR, which caused a longer performance time with CPR as compared to ACD-CPR; (b) the overall absence of physiological differences between ACD-B and ACD-S; and (c) a modest decrease in mechanical efficacy for ACD-S when compared to ACD-B.

Adult↗

PubMed1998

Metallic fragment deposits during phacoemulsification.

PURPOSE: To describe the nature and origin of foreign metallic intraocular bodies appearing after phacoemulsification. SETTING: Department of Ophthalmology, University Hospital of San Juan, Alicante, Spain. METHODS: Two metallic particles, 1 extracted during surgery and the other from a patient in whom surgery had been performed, were studied by scanning electronic microscopy and X-ray dispersive energy spectroscopy. Also evaluated were all metallic elements used in phacoemulsification including phaco tips, Sinskey hooks, and handpieces. A morphologic analysis at various magnifications was performed and the composition of the elements studied. RESULTS: Scanning electronic microscopy showed irregularities of the phaco tip and Sinskey hook after their use. Spectrographic analysis found that the phaco tip was mainly aluminum and titanium; the Sinskey hook, iron, chromium, cobalt, and nickel; the handpiece, iron, chromium, and nickel; and the 2 metallic particles, iron, chromium, and nickel, the same as the handpiece. CONCLUSION: The metallic particles extracted corresponded to those of the phaco handpiece. Vibration during prolonged use of the phacoemulsifier probably caused these particles to chip off the handpiece.

Alloys↗

PubMed1998

Clinical results of AcrySof intraocular lens implantation.

PURPOSE: To analyze the clinical results of AcrySof intraocular lens (IOL) implantation. SETTING: San Juan University Hospital, Alicante, Spain. METHODS: This retrospective study comprised 100 patients with cataract 81 without previous eye pathology and 19 with previous eye pathology (i.e., diabetes, traumatic cataract, central corneal leukoma, glaucoma). Phacoemulsification technique depended on the type of cataract. Mean follow-up was 9 months. RESULTS: Best corrected visual acuity was 20/40 or better in 11.52% of patients with preoperative eye pathology and in 100% of those without pathology. CONCLUSION: Implantation of AcrySof IOLs did not result in complications or adverse reactions in our series, indicating that its use is safe in small incision cataract surgery.

Acrylates↗