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Biomedical subjects

J L Rodriguez

Publications and source records attributed to J L Rodriguez.

At least 73 records · Page 4Linked to original sources
PubMed1996

Immunohistochemical and ultrastructural characteristics of Mycoplasma capricolum subsp. capricolum in caprine abortion: a case report.

Described in this study are the immunohistochemical and ultrastructural findings in a case of caprine abortion due to the experimental infection of the dam with strain GM13 of Mycoplasma capricolum subsp. capricolum. Mycoplasma antigens were seen mainly in choriallantoic trophoblasts and in the lumen of blood vessels in the allantoic membrane. Examination with an electron microscope showed that the chorioallantoic trophoblasts were filled with typical mycoplasma organisms. No other bacteria were observed in any of the samples. Our results confirm by immunohistochemical and electron microscopic techniques that Mycoplasma capricolum subsp. capricolum can cause caprine abortion and that the process can occur without premonitory signs.

Journal Article↗
PubMed1996

A comparison of bronchodilator responses to albuterol delivered by ultrasonic versus jet nebulization in moderate to severe asthma.

BACKGROUND: Nebulization of beta-agonists is preferred as a mode of treatment in moderate to severe asthma. Few studies, however, have compared its use in this population using an ultrasonic versus a jet nebulizer. OBJECTIVE: The purpose of the study was to compare bronchodilator responses to albuterol between an ultrasonic and a jet nebulizer in moderate to severe asthma. METHODS: Fifteen stable, moderately to severely asthmatic patients were randomized to receive the ultrasonic or jet nebulizer for 2 weeks. They were then crossed over for an additional 2 weeks. Albuterol was the agent used. The bronchodilator response was measured at baseline, and up to four hours after treatment with each nebulizer. Daily peak flows were then done for 2 weeks. RESULTS: The maximal percentage of increase in FEV1 at 30 minutes using the ultrasonic nebulizer was 39.9 +/- 8% (P < 0.001) versus 25.1 +/- 7.6% (P = .005) using the jet nebulizer. There were no other differences between the ultrasonic and the jet nebulizer in FEV1 or FVC during the 4-hour spirometry. During the home trial, the difference in evening PEFR between the jet nebulizer (69.05 +/- 14.9 L/min) and the ultrasonic nebulizer (90.11 +/- 18.7 L/min) was significant (P = .04). CONCLUSIONS: In summary, the ultrasonic and the jet nebulizer produced comparable bronchodilator responses to albuterol in stable moderately to severely asthmatic patients.

Adolescent↗
PubMed1996

Early placement of prophylactic vena caval filters in injured patients at high risk for pulmonary embolism.

OBJECTIVE: Pulmonary embolism (PE) is a major problem in patients with multiple injuries. We present our experience with early placement of prophylactic vena caval filters (VCFs). DESIGN: Prospective study group with historical control. MATERIALS AND METHODS: From March 1993 to December 1993, VCFs were placed in 40 consecutive patients with three or more risk factors for PE and had demographic, physiologic, venous thromboembolic prophylaxis, and outcome data collected prospectively (VCF group). They were compared to 80 injured patients admitted between November 1991 and February 1993 who survived > 48 hours and who were matched with the VCF group for mechanism of injury and risk factors for PE (NO VCF group). MEASUREMENTS AND MAIN RESULTS: VCF placement affected a significant reduction in the incidence of PE (2.5% vs. 17%) and a clinical reduction in PE-related mortality. Embolic trapping was suggested by a 10% incidence of documented vena caval thrombi and although two patients developed significant venous stasis disease, no other VCF-related morbidity was noted. CONCLUSIONS: In spite of long-term morbidity, early prophylactic VCF placement is safe and should be considered in the prophylaxis of PE in the high-risk injured patients. This intervention may be effective in eliminating PE as a major cause of posttrauma morbidity and mortality.

Adult↗
PubMed1996

Blunt force injury of the abdominal aorta.

OBJECTIVE: To review the clinical presentation, diagnosis, and management of injury to the abdominal aorta after blunt force trauma. DESIGN: This study was a retrospective review. RESULTS: A total of 5,676 patients were admitted to the University of Michigan Medical Center with traumatic injury. Seven had injuries to the abdominal aorta after a blunt force mechanism. Five patients had operative repair of the aortic injury, of which four involved orthotopic graft placement and one had an extra-anatomic bypass. Two patients had the aortic injury repaired by endovascular stent placement in the angiography suite. One patient died, and lower extremity amputations were performed in three patients. CONCLUSIONS: Surgical repair of abdominal aortic injury is preferable for the unstable patient or those with threatened extremities. In the stable patient with viable limbs, treatment with radiologic placement of endovascular stents may provide a nonoperative option for management.

Adult↗
PubMed1996

An immunohistochemical method of detecting Mycoplasma species antigens by use of monoclonal antibodies on paraffin sections of pneumonic bovine and caprine lungs.

Lung samples from pneumonic lesions in cattle and goats, naturally or experimentally infected with strains of the Mycoplasma mycoides cluster, were fixed in formalin and embedded in paraffin. An immunohistochemical technique using monoclonal or polyclonal antibodies was performed on tissue sections in order to detect Mycoplasma antigens. Four monoclonal antibodies (MAbs), one (2A3) raised against M. mycoides ssp. mycoides small colony (SC) and large colony (LC), two (1D3 and 5E5) against M. mycoides ssp. capri, and one (5A10) against M. bovis, were used. A range of polyclonal antibodies, raised to the individual subspecies of the M. mycoides cluster, and one to Pasteurella haemolytica, was also used. The MAb 2A3 showed positive immunostaining in lung sections from cattle and goats naturally and experimentally infected with M. mycoides ssp. mycoides SC and LC, but not with pneumonic lesions of cattle and goats due to other members of the M. mycoides cluster, M. bovis or Pasteurella spp. The MAb 1D3 showed immunostaining in lung sections from goats naturally and experimentally infected with M. mycoides ssp. capri, but again not with pneumonic lesions caused by other members of the M. mycoides cluster, M. bovis or Pasteurella spp. The MAb 5E5 immunoreacted in sections from pneumonic lesions from all animals infected with one of the three M. mycoides cluster subspecies used in the study, but not with M. bovis or Pasteurella infected tissue. Immunoreaction was mainly found in the cell debris around necrotic areas, as well as in macrophages, neutrophils and epithelial cells. The localization of antigens of the M. mycoides cluster using polyclonal antisera followed basically the same pattern as that obtained with the monoclonals. However, a wide cross reactivity was found between different antisera and relatively high background immunostaining was also seen, especially in necrotic areas. The results suggest that immunohistochemical methods using monoclonal antibodies are useful tools for the diagnosis and study of the pathogenesis of pneumonia caused by the Mycoplasmas of the M. mycoides cluster.

Animals↗
PubMed1995

Pseudoaneurysms of the intraparenchymal splenic artery after blunt abdominal trauma: a complication of nonoperative therapy and its management.

The presentation, diagnosis, and successful management of posttraumatic pseudoaneurysms of the intraparenchymal splenic artery after nonoperative therapy in an adult patient is described. Pseudoaneurysm formation of the intraparenchymal splenic artery is a rare complication of traumatic splenic injury, which is a potential mechanism of delayed splenic rupture and demonstrates the importance of follow-up in the nonoperative therapy of blunt injury to the spleen.

Adult↗
PubMed1995

Biliary tract injury following blunt abdominal trauma: case reports.

This report reviews three cases of biliary tract injury following blunt abdominal trauma. During diagnostic evaluation, computerized tomography failed to delineate the injuries, but endoscopic retrograde cholangiopancreatography (ERCP) aided in the diagnosis in two patients and pre-operative biliary stent placement facilitated operative intervention. Surgical exploration was required to fully characterize the injury in all three patients.

Abdominal Injuries↗
PubMed1995

Volatile anesthetic modulation of lung injury and outcome in a murine model of multiple organ dysfunction syndrome.

General anesthesia has been shown to have a significant impact on the inflammatory response. We hypothesized that lung pathophysiology will be attenuated in a mouse model of secondary multiple organ dysfunction syndrome (MODS) elicited by intraperitoneal zymosan suspension in saline. CD-1 mice were anesthetized for 6 h with either 1% halothane or 1.5% isoflurane in 30% oxygen in N2 carrier gas. Another group of mice was exposed to 30% oxygen in N2 carrier gas only. The inflammatory response to zymosan was quantified by measuring lung myeloperoxidase activity (neutrophil recruitment). Lung injury was estimated by determining the degree of lung permeability to radioactive albumin (permeability index). Unanesthetized injured mice exhibited maximal lung myeloperoxidase activity 2 h after zymosan injection (.671 +/- .07 delta OD.min-1), which was significantly attenuated (p < .01) in injured mice anesthetized with halothane (.369 +/- .054) and isoflurane (.324 +/- .055). The maximum lung permeability index occurred 8 h after injection in the unanesthetized, injured mice (.398 +/- .019), and was attenuated (p < .01) in injured mice anesthetized with halothane (.255 +/- .02) and isoflurane (.224 +/- .019). Histopathological findings corresponded to the quantitative myeloperoxidase and permeability index values. Halothane and isoflurane attenuate lung inflammation and injury in this mouse model of multiple organ dysfunction syndrome. This attenuation may be related to modulation of the inflammatory response by volatile anesthetics.

Anesthetics, Inhalation↗
PubMed1995

Multiple organ dysfunction syndrome: end organ and systemic inflammatory response in a mouse model of nonseptic origin.

The authors measured the peripheral blood pro-inflammatory cytokine responses (tumor necrosis factor-alpha [TNF-alpha] and interleukin-6 [IL-6]) and related end organ responses ti intraperitoneal zymosan-saline suspension over 5 days in CD-1 mice. Other indicators of local and systemic inflammation included wet:dry weight ratios of lung, liver, kidneys, spleen, and bowel; peripheral blood hematocrit, white blood cell count, and platelet count; lung myeloperoxidase activity; lung protein leak; and bacterial translocation to liver, spleen, and mesenteric lymph nodes. The initial event in responses to zymosan A injection was a sharp rise in the peripheral blood TNF-alpha level, which crested within 1 h of injection. This response was followed by a peripheral blood leukocytosis also within 1 h, and a peak lung myeloperoxidase activity within 1-2 h of injection. The maximum lung permeability index occurred 8 h after injection (zymosan, .398 +/- .019 [n = 10]; saline vehicle, .266 +/- .007 [n = 10], p < .001) followed by the maximum lung wet:dry weight ratio, which occurred 18 h after injection. The peak wet:dry weight ratios for the other organs occurred between 12 and 24 h after injection as well. Peripheral blood IL-6 maxima followed TNF-a maxima after lags of several hours. The release of pre-formed TNF-a is likely the most proximal event following injection of zymosan, and may set in motion the processes that result in end-organ injury and secondary multiple organ dysfunction, particularly activation of leukocytes. The precise roles of TNF-alpha and IL-6 in the pathogenesis of end-organ injury, however, are not addressed.

Animals↗
PubMed1994

Burn wounds: infection and healing.

Early wound closure is the ultimate goal of burn care. While excisional therapy is necessary in the treatment of both large, full-thickness and deep, partial skin-thickness burns, the majority of burns are superficial partial skin-thickness injuries requiring a different clinical approach. In superficial wounds, cosmetic and functional restoration in conjunction with relief from pain and prevention of infection is as important as rapid wound closure. The moist wound healing associated with hydrocolloid dressings may provide an alternative treatment modality for certain partial-thickness injuries. In comparable wounds, these dressings produce good functional and cosmetic results, rapid reepithelialization, and improved patient comfort.

Burns↗
PubMed1994

Donor site repair.

Delayed healing of skin donor sites may be costly and life threatening, especially in patients with large body-surface area burns. A donor site dressing should maximize the ability of the wound to heal without increasing the risk of local infection, systemic infection, or both. Specifically, the possibility of a secondary infection may either slow the healing process or ultimately convert the donor site to a full-thickness wound. A number of materials, ranging from gauze to biological agents, have been investigated for use as donor site dressings. The use of hydrocolloids for donor sites has been studied extensively, and, compared with conventional dressings, improved healing rates are reported. Our recent study using a hydrocolloid dressing confirmed earlier research showing fewer infections and more rapid donor site healing.

Bacterial Physiological Phenomena↗
PubMed1994

Simultaneous traumatic ascending and descending thoracic aortic rupture.

A case of a 56-year-old male blunt trauma victim with combined simultaneous ascending and descending thoracic aortic rupture is presented. He was successfully treated with immediate operation for the ascending aortic rupture and a delayed approach, with nonoperative stabilization and later repair, due to poor pulmonary status and a question in diagnosis, for the descending aortic rupture.

Aorta↗
PubMed1994

The contribution of open extremity fractures to infection in multiply injured patients.

We sought to determine whether a contaminated open fracture was a reliable component for calculating the Outcome Predictive Score in patients with multiple injuries. We studied 41 patients whose primary source of contamination was open extremity fractures. Only one of the 41 patients developed osteomyelitis. The rate of infection from an open fracture is minimal in the multiply injured patient. Inclusion of patients with open fractures in studies that assess the likelihood of infection and the value of anti-infective agents incorrectly identified patients for clinical trials and results in an overestimation of survival based on the Outcome Predictive Score. These findings suggest that open fractures should be excluded as an entry criterion in future clinical trials.

Bacterial Infections↗
PubMed1994

Antibiotic overkill of trauma victims?

Antibiotic usage was assessed in a prospective, randomized trial of recombinant interferon-gamma (rIFN-gamma) versus placebo for 212 severely injured trauma patients in four university hospitals. All patients were observed until death or discharge from the hospital. We found the number of antibiotics used and their associated costs staggering and difficult to justify, although serious antibiotic-related complications were infrequent. Regular antibiotic administration following severe trauma should be re-evaluated since clinical evidence supports the use of shorter courses for these patients, with presumed similar outcomes and much-reduced expenses.

Adolescent↗