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Biomedical subjects

J Freire

Publications and source records attributed to J Freire.

33 records · Page 2Linked to original sources
PubMed1989

[Changes in the activity of plasma renin and aldosterone induced by a pattern of increasing administration of zinc sulphate in normotensive individuals].

The behavior of the renin-angiotensin-aldosterone system was evaluated in response to an increasing zinc intake. This oligoelement can modify the activity of the angiotensin I converting enzyme (ACE). Six healthy normotensive volunteers received 30 mg of zinc sulphate orally for 4 days and 600 mg for 4 additional days. On the first, fifth and ninth days plasma renin activity (PRA) and serum aldosterone were measured, and the possible changes in blood pressure were evaluated. PRA and aldosterone showed significant increases, with a stepwise distribution throughout the zinc overload. On the first day, PRA was 0.40 +/- 0.08 ng/ml/h; on the fifth day it was 0.80 +/- 0.21 ng/ml/h, and on the ninth day 1.39 +/- 0.34 ng/ml/h (1st-5th day; p less than 0.05; 1st-9th day: p less than 0.02). On the first day, the aldosterone levels were 81 +/- 17 pg/ml, on the fifth day they were 119 +/- 26 pg/ml, and on the ninth day 164 +/- 30 pg/ml (1st-5th day: nonsignificant difference; 1st-9th day: p less than 0.02). The values of arterial pressure did not change significantly after zinc overload. It is concluded that zinc overload can modify PRA and aldosterone levels, and that these changes are dose-related.

Adult↗
PubMed1989

[Intermediate thalassemia. Study of 5 cases in their clinical, ferrokinetic and erythrokinetic aspects].

Five cases of thalassaemia intermedia are reported, they being considered from clinical and biologic standpoints. All patients had long-lasting anaemia, variable enlargement of spleen and low transfusion requirements. The ferro-erythrokinetic pattern was that of chronic haemolysis with effective erythropoiesis, and some comments are included on the different patterns found in each genetic variety. None of the patients is subjected to a defined transfusion protocol.

Diseases in Twins↗
PubMedDate not supplied

[Design of an expert system for decision-making in an emergency situation].

OBJECTIVES: To study the clinical applicability of the expert system URGSANT as a help in making up decisions in emergencies. MATERIAL AND METHODS: URGSANT is an expert system implemented in INSIGT 2+ which is structured in a modular and hierarchical form. It contemplates 44 urgent situations relating to the central nervous system, hematopoietic, cardiovascular, respiratory, gastrointestinal, genitourinary, endocrinological, and miscellaneous group. Validation of the program was made by four anesthesiologists who evaluated the performance of the program in 25 emergency cases and in 25 other situations that were treated by other specialists. RESULTS: The rationale of the system was basically correct. In most cases the program was considered efficient or very efficient during the different clinical situations and only in one case its guidance was wrong. CONCLUSIONS: The URGSANT expert system is an efficient and useful method for the clinician during emergency situations.

Anesthesiology↗
PubMedDate not supplied

[Changes in plasma cortisol and ACTH caused by diazepam, bromazepam, triazolam, and alprazolam in oral premedication].

INTRODUCTION: Benzodiazepines relieve anxiety and modify the endocrine response to surgical-anesthetic stress. OBJECTIVES: The aim of this study was to evaluate the effects of four benzodiazepines on preoperative secretion of cortisol and ACTH. MATERIAL AND METHODS: We studied 60 patients programmed for abdominal surgery. Patients were randomly allocated into six groups of treatment: control group (placebo), diazepam 10 mg, triazolam 0.5 mg, alprazolam 0.5 mg, bromazepam 6 mg, and bromazepam 12 mg. Blood samples for cortisol and ACTH measurements were obtained at five different stages of the anesthetic-surgical procedure: baseline, preanesthesia, anesthesia, surgery, and postoperative phase. RESULTS: Diazepam and bromazepam (6 and 12 mg) lessened the increase in plasmatic cortisol induced by preanesthesia and anesthesia in control patients. Triazolam attenuated the cortisol response only during preanesthesia. Administration of 12 mg of bromazepam decreased ACTH levels during preanesthesia and anesthesia with respect to the control group. CONCLUSIONS: Benzodiazepines failed to modify cortisol and ACTH levels during surgery and during the immediate postoperative period. The most marked attenuation of adrenocortical response was achieved with 12 mg of bromazepam and the less marked lessening was induced by 0.5 mg of alprazolam.

Adrenocorticotropic Hormone↗
PubMedDate not supplied

[Tracheal rupture during a transhiatal esophagectomy without thoracotomy. Intra- and postoperative treatment].

We report the case of a male patient with a carcinoma of the upper third of the esophagus who presented a tracheal rupture during a transhiatal esophagectomy. The clinical picture was characterized by a severe alteration of the ventilatory function that required selective intubation and, later on, a right thoracotomy for repairing the tracheal lesion. After surgery the patient was treated at the Recovery Unit. He received high-frequency mechanic ventilation (jet ventilation type) during nine days in a attempt to decrease the risk for dehiscence of the tracheal suture and to ensure an adequate oxygenation and hemodynamic control. The clinical course was favourable.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

[The first operations performed with chloroform in Spain. More facts and new contributions].

Although the issue of clinical introduction of chloroform in Spain was rather controversial, we can assure now with no doubt that first news of its discovery reached our country by the end of November and beginning of December of 1847. The cities first receiving those first news were Cádiz, Madrid, Barcelona, and Santiago de Compostela; in the latter two cities, during the first days of December, the new anesthetic agent was already available and the first experiments on dogs were conducted in 19th Sunday and first clinical assays in Barcelona and in Santiago de Compostela, the first experiments in Spain, were carried out in December 20th. Spanish scientific and daily press, particularly, press of Barcelona and Madrid promptly reflected the events and informed their readers about the discovery of chloroform as anesthetic. Our research deals with some of these aspects and we believe that will contribute to clarify not fully studied points to date.

Anesthesia, General↗
PubMedDate not supplied

[Eutopic parturition: psychoprophylaxis or extradural analgesia. Influence on the endocrine response].

Prolactin, ACTH, cortisol and HGH levels have been studied on 30 pregnant women in three different periods: during the labour, at the delivery and 24 hours later. They were divided into 3 groups depending on the analgesia: I) no analgesia (n = 10); II) psychoprophylaxis (n = 10), and III) extradural analgesia (n = 10). Prolactin levels increased during delivery and 24 hours later. A significant increase of ACTH levels (p less than 0.01) was observed during the delivery in the 3 groups even though they were under hasal values 24 hours later. Cortisol increased 38% (p less than 0.01) and 52% (p less than 0.02) in II and III groups, respectively during the delivery. No difference was found with HGH. Our results suggest that endocrine response modified by labour and delivery doesn't change with different analgesia techniques.

Adrenocorticotropic Hormone↗
PubMedDate not supplied

Enterocutaneous fistulas: an unusual solution.

Enterocutaneous fistulas are not a minor problem in gastrointestinal tract surgery. Significant reduction of mortality and morbidity has been attained but they still remain high. The authors report three clinical cases in which they sealed and treated enterocutaneous, chronic, iatrogenic fistulas by injecting biological glue (N-Butil 2-Cyanoacrylate-Histoacryl) into the internal opening and fistulous tract. We believe that the technic we propose here, in the proper setting, may be an important contribution to the management of iatrogenic (postoperative) enterocutaneous fistulas.

Adult↗