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Biomedical subjects

J M Ramos

Publications and source records attributed to J M Ramos.

At least 19 recordsLinked to original sources
PubMed1992

[Pulmonary artery involvement in Takayasu arteritis. A case of right ventricular failure as presentation form].

Pulmonary involvement in Takayasu's artery disease has been reported since 1940 with an incidence of 14 to 56%. However, the development of severe pulmonary hypertension is an extremely rare event in the natural course of the disease. The authors report a case of a 62 year old male presenting with severe congestive heart failure of recent onset. The initial evaluation and routine exams suggested the presence of pulmonary hypertension of unknown etiology. The absence of left radial pulse in the physical examination led to the performance of a complete angiographic study which confirmed the diagnosis of Takayasu's arteritis with pulmonary involvement and severe pulmonary hypertension.

Heart Failure↗
PubMed1992

[Primary pulmonary hypertension. Clinico-pathologic analysis].

We present a case of primary pulmonary hypertension, confirmed by open lung biopsy. The interest of the case resides in the microscopic study of the specimen, and the patient's prognosis is discussed. The physiopathology of the disease is reviewed and the palliative therapeutic measures that can be adopted.

Adult↗
PubMed1991

[Value of two-dimensional echocardiography in the prognosis of patients after acute myocardial infarction].

OBJECTIVES: To evaluate the prognostic importance of two-dimensional echocardiography in patients (pts) with acute myocardial infarction. SETTING: Department of Cardiology in a Central Hospital. METHODS: In 71 pts (63 men and 8 women) aged 35 to 75 years interned with a proved myocardial infarction, a score of left ventricular segmental wall motion was used on echocardiographic examination performed during the late hospital phase, to evaluate left ventricular function. Two groups of pts were considered: group A constituted by 38 pts with complication detected during follow-up that ranged 4 to 18 months; group B by 33 pts with no cardiac events for the same period. The relation of the wall motion score with each group and the location of myocardial infarction was performed. RESULTS: In group A, the mean score index was 1.67 in pts with angina, 1.08 in pts with heart failure and 0.82 in pts who died. The mean score index was 1.25, 1.57 and 1.18 respectively in pts with an anterior, inferior and antero-inferior infarction. In group B, the mean score index was 1.70 in pts with an anterior infarction, 1.85 in those with an inferior infarction and 1.33 in the patient with an antero-inferior infarction. Patients with a non-Q wave infarction had a mean score index of 2. The mean score index was significantly different between group A and B (respectively 1.33 vs 1.79; p less than 0.00001) and a mean score index of 1.53 was considered the mean risk value. CONCLUSIONS: Two-dimensional echocardiography performed during hospital predischarge permits risk stratification after acute myocardial infarction, specially for death and heart failure.

Adult↗
PubMed1990

[Non-invasive evaluation of systolic pressure of the pulmonary artery in patients with tricuspid regurgitation, using Doppler echocardiography].

STUDY OBJECTIVE: To quantify the systolic pulmonary artery pressure (SPAP) by continuous wave Doppler echocardiography and record the prevalence of tricuspid regurgitation (TR). DESIGN: Prospective analysis of 42 patients (pts), submitted to right heart catheterization (RHC). SETTING: Pts referred to the Echocardiographic Laboratory at Sta. Marta Hospital - H.C.L. PATIENTS: Sequential sample of 42 pts with several cardiac pathologies, subjected to RHC and 2D Doppler Echocardiography. INTERVENTIONS: The right ventricular and SPAP were recorded in the hemodynamic exam. We considered pulmonary hypertension (PH) if SPAP was greater than 35 mmHg or mean pressure greater than 20 mmHg. The pts were divided into two groups: I-pts without PH and II-pts with PH. The 2D Doppler echocardiography was made within 24 H of the hemodynamic one. Peak gradient (pg) of TR and the correlation with catheterization data were analysed. RESULTS: Hemodynamic--The mean SPAP in the sample was 46 +/- 21.5 mmHg (27 +/- 4.6 in group I and 55 +/- 20.2 mmHg in II). In 35 pts with TR the mean SPAP was 50.3 +/- 21.2 mmHg. Doppler--The pressure gradient was 40 +/- 18.7 mmHg. 57% pts of the group I and 96% II had TR p less than 0.001. The correlation between Doppler gradient and SPAP was r = 0.95, and no change was noted when 7 is used as a constant. CONCLUSION: Continuous wave Doppler echocardiography is a non invasive technic useful to the quantitative analysis of SPAP.

Adult↗
PubMed1989

Peripheral pathways mediating salivary secretion after nucleus parvocellularis activation in the rat.

The present study demonstrates that activation of the nucleus parvocellularis in the pontine reticular formation of the rat evokes salivary hypersecretion. The secretory effect observed was found to be mediated by parasympathetic mechanisms, as transection of the preganglionic parasympathetic salivatory fibers at the level of the middle ear blocked the flow of saliva evoked by activation of the nucleus parvocellularis (Experiment 1). Furthermore, transection of these salivatory fibers was followed several days later by the development of a prandial model of drinking. These behavioral data suggest that the transection procedure employed in the present study indeed affected those parasympathetic fibers which control the secretory activity of all three pairs of major salivary glands (Experiment 2).

Animals↗
PubMed1989

Effects of atropine injection on food-associated drinking in rats with superior salivatory nucleus lesions.

The neuropharmacological mechanisms involved in the prandial drinking pattern seen in rats with superior salivatory nucleus lesions + parotidectomy were investigated with behavioral methods. Results showed that the administration of low doses (0.1 mg/kg body wt) of atropine in lesioned rats potentiated previously established prandial drinking. Higher doses of atropine (1.0 mg/kg), however, were required to induce a similar degree of prandiality in control rats (parotidectomy alone). These findings suggest that the salivatory nucleus lesions affected a cholinergic brainstem-salivary gland system involved in the neural control of food-associated drinking.

Animals↗
PubMed1989

[Flow patterns of a normally functioning monocuspid aortic prosthesis evaluated using Doppler echocardiography].

STUDY OBJECTIVE: Flow analysis in normally functioning eccentric monocuspid aortic prosthetic valves, to obtain a reference data list. DESIGN: To analyse, using 2D-Doppler Echocardiography, aortic flow velocity and systolic time intervals in clinically normal patients (pts), by physical examination. SETTING: Referred pts to the Echocardiographic Laboratory at Santa Marta Hospital--HCL. PATIENTS: Sequential sample of 61 pts with aortic prosthesis (41 Bjork-Shiley and 20 Hall-Kaster) without clinical evidence of either cardiac failure or significant aortic regurgitation. Patients with bad quality record were also excluded. INTERVENTIONS: Doppler Echocardiography was used to record transaortic flow, and the following indexes were analysed: instantaneous peak velocity (pv) and gradient (pg), presence of regurgitation, systolic time intervals and both preejection period/ejection time (PEP/ET) and acceleration time/ejection time (AT/ET). RESULTS: Pv ranged from 1.1 to 4 m/sec (mean 2.4 +/- 0.2. The prosthesis size 19 and 21 showed a greater pg compared to the larger ones: 46.3 +/- 14.4 mmHg against 12.6 +/- 6.4 mmHg (p less than 0.001). Occasionally a pg over 50 mmHg was found in the prosthesis size 19 and 21. The correlation between prosthesis size and pg was also significant (r = -0.62; p less than 0.001). PEP interval was 60 +/- 10 milisec in prosthesis no. 19 and 90 +/- 13 milisec in no. 27 (p less than 0.01). AT ranged from 77 +/- 14 to 88 +/- 14 milisec (mean 82 +/- 13). ET was 294 +/- 5.4 milisec in valves size 19 and 257 +/- 34 millisec in no. 25 (p less than 0.05); there was also a significant difference between prosthesis size 19 and 27 (p less than 0.05). Mild regurgitation was detected in 32.7% of cases. CONCLUSIONS: These data may be particularly useful as reference values to the follow-up of pts these types of prosthesis. Significant differences were found in pg between different valve sizes and this should be remembered when proceeding to standard evaluation by 2D-Doppler Echocardiography. Regurgitation is frequently detected in normally functioning prosthesis, not deeper than 2 cm in the left ventricle.

Adult↗
PubMed1988

Legionnaires' disease in a Johannesburg teaching hospital. Investigation and control of an outbreak.

During the period 11 November 1985 - 21 February 1986, 12 cases of Legionnaires' disease were identified at a Johannesburg teaching hospital. Only 2 patients definitely acquired the disease in hospital. Both responded well to treatment. An epidemiological investigation was initiated to determine the source of infection and mode of transmission of the causative agent (Legionella pneumophila), which may be recovered from a wide variety of water sources. Although L. pneumophila was cultured from the hospital hot-water system, there was no association between the location of patients and culture-positive water sites. Cases were clustered in the medical and surgical intensive care units. Being on a ventilator was a significant risk factor for acquiring Legionnaires' disease (relative risk 18,4; 95% confidence interval 2,4 - 142,2). The potential role of ventilators in the transmission of the disease is discussed together with the infection control measures adopted to interrupt the outbreak. To our knowledge this is the first investigation of an outbreak of Legionnaires' disease in South Africa.

Adult↗
PubMed1988

Submandibular and parotid salivary secretion after electrolytic lesioning of the brainstem nucleus parvocellularis in the rat.

The present study, in consonance with recent anatomical investigations, demonstrates that activation of the nucleus parvocellularis in the rat evokes a potent hypersecretory effect in the submandibular and sublingual (S-S) salivary glands. Furthermore, electrolytic lesioning of this region in conjunction with peripheral removal of the parotid glands is followed by an increase in the number of drinking responses in the presence of dry food. Such prandial drinking behavior is only observed after total impairment of salivation (i.e., removal of the S-S + parotid glands), thus suggesting that the parvocellularis lesion led to a marked deficit in S-S salivary secretion. On the other hand, the activation of the nucleus parvocellularis was seen to have only a slight effect on parotid salivary secretion. Electrolytic lesions to this zone, when associated with peripheral removal of the S-S glands, failed to induce prandiality, suggesting that the parvocellularis nucleus exerted a low level of control over parotid salivary secretion. These results are interpreted as functional proof of the relationship between the parvocellularis reticular formation and the superior salivatory nucleus in the secretion of S-S saliva.

Animals↗
PubMed1988

The nucleus parvocellularis reticularis regulates submandibular-sublingual salivary secretion in the rat: a pharmacological study.

This experiment shows that activation of the nucleus parvocellularis reticularis in the rat brainstem provokes salivary hypersecretion by the submandibular-sublingual glands. The secretory effect is mediated by cholinergic mechanisms, as the administration of atropine blocked the flow of saliva evoked by stimulation of the nucleus parvocellularis. In contrast, injection of dihydroergotamine (an alpha-blocker) and/or propranolol (a beta-blocker) failed to significantly reduce submandibular and sublingual salivary secretion when compared to a control group injected with distilled water. The cholinergic nature of the salivary response suggests that the nucleus parvocellularis reticularis exerts its secretory effect on the salivary glands parasympathetically rather than through mechanisms associated with sympathetic pathways. The area of the brainstem activated in the present study closely overlaps the region in which cell bodies of superior salivatory neurons have recently been identified with retrograde transport of peroxidase. The data presented herein represent functional proof in support of the location of the superior salivatory nucleus within the parvocellularis reticular formation.

Animals↗
PubMed1988

Salivatory neurons in the brainstem nucleus parvocellularis of the rat: effects of electrolytic lesions.

This study was based on several recent anatomical studies suggesting that the superior salivatory nucleus is located within the area parvocellularis of the brainstem reticular formation. The aforementioned zone was lesioned in order to observe the alterations produced in salivary secretion. Electrolytic lesion of the area parvocellularis was followed by salivary hypersecretion as an immediate and transitory effect of the stimulatory capacity of the electrolytic lesioning method. Some days later the animals presented a markedly impaired salivary secretion as shown by the appearance of inefficient feeding behavior and the development of a prandial drinking pattern. The prandial behavior, which was characterized by numerous drinking episodes during dry food intake, was reversed when wet food was offered, suggesting a true deficit in salivary secretion caused by the parvocellularis lesion. Following the administration of pilocarpine, the submandibular and sublingual salivary glands of experimental animals showed an increased capacity for response (postsynaptic supersensitivity) in comparison to the control group.

Animals↗
PubMed1985

Urographic findings in adults with chronic pyelonephritis.

The radiological findings in a cohort of 138 adults with chronic pyelonephritis are presented and the following conclusions made. Scarring is commoner in the right kidney than the left and is found in the upper, middle and lower poles with decreasing frequency from above down. Agreement between observers in the grading of scarring in urograms taken without standardisation or routine tomography, is sufficiently high to justify the continued use of the intravenous urogram as a screening test but is not high enough to detect any progression of scars in the group over a 6.5-year period. Repetition of urograms seldom reveals the development of calculi or other new abnormalities and is not justified as a clinical routine. The combination of extensive bilateral renal scarring and proteinuria is associated with the worst renal function.

Adult↗