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Biomedical subjects

J Muñoz

Publications and source records attributed to J Muñoz.

At least 181 records · Page 10Linked to original sources
PubMed1989

Comparative study of two different routes for insulin administration in CAPD diabetic patients. A multicenter study.

CAPD has been considered an appropriate method for treatment of diabetics in renal failure. Up to now the choice of route for insulin administration in these patients has not been definitely defined, although there is a general consensus for employing the intraperitoneal route for this purpose. However, contradictory data have appeared on this subject. Our aim has been to investigate whether the subcutaneous or intraperitoneal route makes any difference to metabolic control, and if so what is the price in terms of the incidence of peritonitis. Two groups of diabetic patients from three different hospitals with a similar peritonitis incidence and training protocols were studied. Of the 30 patients, 15 were treated with subcutaneous insulin (sc group) and in the other 15 the intraperitoneal route was employed (ip. group). The average follow-up period was 20.8 +/- 7.5 months for sc group and 18.7 +/- 8 months for ip. group. Insulin requirements were 30 +/- 11 u./day in the sc. and 110 +/- 60 u/day in the i.p. group (p less than 0.05) and remained constant during the study period. Metabolic controls (home glucose levels, HbA1C, hospital fasting glucose levels) were similar for both groups. However, the incidence of peritonitis was 4 times greater in the ip. group. In the ip. group 18 peritonitis episodes were registered in 280 patient-months vs 5 episodes in sc. group in 312 patient-months. We conclude that the intraperitoneal route for insulin administration in diabetic CAPD patients produces a higher risk of suffering peritonitis with no real metabolic improvement in the medium term.

Blood Glucose↗
PubMed1989

Induced changes of the peritoneal diffusion capacity by smoking, intraabdominal hypertension and omentectomy.

UNLABELLED: Peritoneal membrane suffers in some CAPD patients changes which modify its functionalism. In order to know whether these changes could be expected or appropriate, it is necessary to explore the general and particular conditions which can alter peritoneal physiology. Three aspects, smoking, intraabdominal hyperpressure and and omentectomy are situations which have not been included in the studies of peritoneal physiology. PATIENTS: The control group was constituted by 23 patients. Diabetics were studied as a separate group, with their own 10 patient controls. Smokers (1-20 cigarettes per day): 15 were non-diabetic patients, 9 were females. Diabetic smokers: 7 patients. Intraabdominal hyperpressure was determined by two big polycycstic kidneys (PCKD) in 8 patients, none diabetic. Omentectomy was performed in 6 non-diabetic and 9 diabetic patients. In all cases the procedure was prescribed because of an early catheter entrapment. Smoker patients show significant higher MTCs values for urea and creatinine than controls, but the slightly lower ultrafiltration value did not reached significant difference. Polycystic kidney patients showed lower MTCs values in respect to controls. Ultrafiltration capacity was similar. Omentectomized patients did not show any differences in respect to controls. In the diabetic patients group, neither ultrafiltration nor MTCs values presented significant differences between the established subgroups. So, smoking did not seem to induce higher MTC values as in the non-diabetic group. In conclusion, and according to the present results, two more situations should be taken into account in the evaluation of the peritoneal membrane dialyzing capacities: smoking, which increases diffusion capacity except for diabetics and PCKD with tow big kidneys, which decreases this capacity.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdomen↗
PubMed1989

[Disaster medicine].

The authors have reviewed the concept of catastrophe from the health care stand-point as well as, that concerning medicine in catastrophies. The basic outlines for planning adequate health care when a massive number of victims have to be attended are pointed-out as well as, the prevention means for possible flare ups of transmissible diseases.

Accidents↗
PubMed1988

Acetylcholinesterase-containing fibers and choline acetyltransferase activity in isolated cerebral microvessels from goats.

Microvessels have been isolated from goat cerebral cortex and caudate nucleus. The purity of the preparations was assessed by light microscopy and by the high enrichment in the marker enzymes alkaline phosphatase and gamma-glutamyltransferase. Choline acetyltransferase activity was detected in the vascular fractions, being significantly higher in capillaries than in larger vessels. Acetylcholinesterase (AChE)-containing fibers were visualized in vessels of different caliber. Vessels with diameters larger than 70-90 microns showed a network pattern of fibers similar to that of pial arteries. In small vessels (10-70 microns) longitudinal or helical fibers were observed with occasional side-branches that surround the vessel. No AChE staining was visualized in isolated capillaries under light microscopy. This study shows that isolated intracerebral microvessels are suitable preparations for histochemical studies of perivascular nerves. Taken together, the biochemical and histological results are in accordance with a cholinergic innervation of the goat intracerebral vasculature.

Acetylcholinesterase↗
PubMed1988

Prevention of post-transfusion non-A, non-B hepatitis by non-specific immunoglobulin in heart surgery patients.

To evaluate the effectiveness of immune serum globulin (ISG) in preventing non-A, non-B hepatitis, 291 heart surgery patients who received blood from voluntary donors were randomly assigned to receive either ISG or no additional protection. ISG was given intramuscularly before and 1 week after transfusion. 98 controls and 100 in the ISG group completed the study. Post-transfusion non-A, non-B hepatitis developed in 11 (11.2%) controls but in only 3 (3.0%) of the ISG group (p = 0.0203). 8 (72.7%) of control group with hepatitis had symptoms, and in 5 (45.4%) the disease became chronic. The disease was self-limiting in all 3 ISG patients affected, and only 1 of them had symptoms. Among those with non-A, non-B hepatitis aminotransferase levels were higher in the controls than in the ISG patients. Incubation periods longer than 8 weeks correlated with a tendency for the disease to become chronic. ISG recipients had shorter as well as more homogeneous incubation periods. ISG could be a safe, low-cost means for preventing post-transfusion non-A, non-B hepatitis which does not call for the discarding of donated blood.

Adolescent↗
PubMed1987

External beam irradiation for T1, T2-3 and T4 transitional cell carcinoma of the urinary bladder.

Fifty-seven patients with T1 transitional cell carcinoma of the bladder, 57 patients with T2-3 and 10 patients with T4 were treated by radical irradiation +/- salvage cystectomy. Thirty-five patients with T1 were treated by transurethral resection (TUR) plus local chemotherapy +/- salvage cystectomy. Eleven patients with T2-3 were treated with 5 X 4 Gy in one week followed by cystectomy while four patients with T2-3 were treated with 40 Gy in 4 weeks also followed by cystectomy. Five patients with T4 were treated with 40 Gy in 4 weeks plus cystectomy. Seven year survival rates are: 69% for T1 treated by radical irradiation, 43% for T1 treated by TUR (p less than 0.02), 36% for T2-3 treated either by radical irradiation or 5 X 4 Gy plus cystectomy, and 18% for T4 treated by radical irradiation. All the survival rates indicated are free of disease and include the cases in which salvage cystectomy was successfully performed. Sixty per cent of the cured patients conserved very good functional bladders. We believe that external beam irradiation plus salvage cystectomy is indicated in the treatment of T1 and T2-3 tumours of the bladder.

Adult↗
PubMed1987

Mycobacterium chelonei peritonitis due to hematogenous dissemination in a continuous ambulatory peritoneal dialysis patient.

Renal failure patients have been found to have a special susceptibility to Mycobacterium infections. In patients undergoing peritoneal dialysis, Mycobacterium chelonei peritonitis, due to penetration through the peritoneal catheter lumen, has been described. In our report, we described a case of disseminated M chelonei infection that began in a Thomas hemodialysis prosthesis and finally resulted in peritonitis of hematogenous origin. The diagnostic and therapeutic peculiarities are discussed.

Adult↗
PubMed1987

Induction, purification and some properties of phage tail-like particles from Myxococcus coralloides D.

Myxococcus coralloides D was lysogenic for a defective prophage. The particles of the defective bacteriophage could be induced by ultraviolet light and mitomycin C, but the particles did not appear in the supernatants, unless the cells were lysed with chloroform. The phage tails were purified by using a two-phase separation method, ultracentrifugation, chromatography through Sepharose 4B, treatment with chloroform, dialysis and centrifugation on a sucrose gradient. The chemical analysis of the purified samples revealed that the phage tails contained only proteins, neither DNA nor RNA. The different parts of the phage tails (sheath, core and baseplate) did not have the same sensitivity to the chemical and physical agents which were assayed.

Bacteriophages↗