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Biomedical subjects

J Muñoz

Publications and source records attributed to J Muñoz.

At least 163 records · Page 9Linked to original sources
PubMed1990

[Human immunodeficiency virus infection at a primary care center].

We report a descriptive study of 56 cases of HIV infection in a primary care center to evaluate its impact on the population on care, the practices at risk, the associated infections and the difficulties for control. The distribution by age, sex and practices at risk is in agreement with most series from our area. Remarkably, there is a greater rate of drug abusers and sexual promiscuity, related with the marginal type of population on care. We found a high prevalence of the most commonly associated infections, tuberculosis, syphilis and hepatitis B. This association justifies screening for these diseases and the use of the adequate prophylactic and therapeutic measures. We found important difficulties for the follow up of these patients. All these facts emphasize the need to approach this increasing health problem from the primary care setting, basically from the health education of the person with practices at risk and the overall follow-up of the involved patients.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[The reasons for medical and nursing appointments in a primary health care center (Barcelona)].

The programmed visit, which is basically generated by the health care team, permits a rationalization of the demand and the introduction of health promoting activities. We have evaluated our motives (medical and nurse practices) for the appointment of patients during 1987. We have also recorded the age, sex, compliance and source of the appointment in a sample of 198 medical and 223 nurse appointments. 62.5% of the appointed visits corresponded to females and more than 50% to patients over 59 years. The most common type of appointment was to control chronic disease, owing to its high prevalence and the protocolization of its care. In individuals under 45 years appointments were mostly for diagnostic approach and to record the clinical history. The implementation of preventive measures appeared as one of the least common causes. Failure to comply was seen in 25%, being higher in patients under age 45 and in the appointments to record the clinical history. These results point to the need of restructuring the concertation priorities. The health problems of the population and its vulnerability are the factors that should guide health planning.

Age Factors↗
PubMed1990

[Tuberculosis in a primary care center in a socioeconomically depressed area: variables associated with giving up treatment].

We report the features of 72 patients with tuberculosis of a low socioeconomical level, seen at the primary care center of Perecamps (Barcelona). We identify the factors associated with giving up therapy. We found a predominance of males and of the 40-59 years age group. In 1988 we found an increased rate of young patients (20-39 years) and PDA/HIV+. Twenty-five patients (35%) had had previous episodes of tuberculosis. 19 had had inadequate chemotherapy because of abandonment. The rate of follow-up losses was high (36%). A history of previous PDA/HIV+ were associated with giving up therapy. We indicate the several measures to be applied in our area to improve compliance with chemotherapy in patients with tuberculosis.

Adult↗
PubMed1990

[Spontaneous pneumomediastinum in adults].

Pneumomediastinum cases admitted to our Respiratory Intensive Care Unit during the past 15 years are reviewed. After excluding secondary and iatrogenic pneumomediastinum, spontaneous pneumomediastinum was diagnosed in seven patients being all of them males. The causative conditions were status asthmaticus in four patients, intense cough in two and Valsalva manoeuver in one patient. The most frequent symptoms were dyspnea, chest pain and odynophagia. Subcutaneous emphysema appeared in six patients and there was associated pneumothorax in two cases. ECG was normal in six patients. All cases of spontaneous pneumomediastinum had a satisfactory evolution with conservative treatment resolving in four to eight days.

Adolescent↗
PubMed1989

Identification of a tumour factor inducing resistance to NK cell lysis.

The mechanisms involved in the resistance or susceptibility of tumour cells to NK cytotoxicity are poorly understood. The role of different molecules on the target cell surface which could act as recognition elements by NK effectors has been postulated. However, there are also some tumour cell lines which release factors capable of inhibiting NK cytotoxicity. This paper presents a new factor (NK-RIF), produced and released by different tumour cell lines, making K562 resistant to NK lysis without affecting the cytotoxic function of NK effector cells. This soluble factor is shown to be thermolabile, non-dialyzable and to have a molecular weight of 36,000 daltons. It does not block the binding capacity of the target and effector cells, nor does it affect target susceptibility to LAK or cytotoxic T-cells.

Adenocarcinoma↗
PubMed1989

Intracranial cavernous angioma in the dura.

Cavernous malformations located in the dura are rare. We present a case of a large cavernous malformation located in the anterior fossa and implanted in the dura of a pregnant woman. It showed great vascularization on an angiogram, and resembled a meningioma on computed tomographic scan. The operation was difficult because of the tumor's great vascularity and profuse bleeding.

Adult↗
PubMed1989

Transvenous ablation with high frequency energy for atrioventricular junctional (AV nodal) reentrant tachycardia.

We performed transcatheter AV junction ablation with high frequency energy in four patients with AV nodal reentrant tachycardia where extensive trials of several antiarrhythmic drugs failed to prevent further recurrences of tachycardia. Initially high frequency catheter ablation induced complete AV block in all patients. A recuperation of AV 1:1 conduction followed some time later, persisting in follow-up. No complications have been encountered in either the acute phase or the follow-up (from 6 to 8 months; mean +/- SD: 8.7 +/- 2.5 months). The electrophysiological study was carried out 6 weeks following ablation, and all patients showed AV 1:1 conduction. No dual nodal pathway was encountered and no tachycardia could be triggered. With refinement of the method, the potential application of high frequency energy to interrupt intranodal or perinodal connections responsible for reentrant supraventricular tachycardia or to retard AV nodal conduction appears promising.

Adult↗
PubMed1989

[Primary spontaneous pneumothorax in 4 siblings].

4 cases of spontaneous pneumothorax in 4 brothers, previously healthy with similar morphometric features and normal levels of alpha-1-antitrypsin, are presented. They all showed a tendency to relapse. The thoracoscopy carried out on one patient did show bullae and pleurodesis with tetracycline was non-effective. There were no functional alterations. We highlight the extremely rare occurrence of familial spontaneous pneumothorax. The literature is reviewed and genetic transmission mechanics is proposed, concluding that difficulties exist in identifying the non-symptomatic genetic carrier. We insist on the need to study family backgrounds in epidemiologic research.

Adolescent↗
PubMed1989

[Alithiasic cholecystitis and sclerosing cholangitis caused by Cryptosporidium and cytomegalovirus in a patient with HIV infection].

A 23-year-old female, an ex-parenteral drug abuser with HIV infection, developed multiple pericholangitic abscesses secondary to lithiasic cholecystitis and sclerosing cholangitis by Cryptosporidium and cytomegalovirus. We emphasize the clinical clues and the diagnostic role of endoscopic retrograde cholangiopancreatography (ERCP), as well as the contribution of the latter to surgical therapy (transendoscopic papillotomy). We also review the reported cases of biliary diseases by Cryptosporidium and/or cytomegalovirus in the literature.

Abscess↗
PubMed1989

Peritoneal functional parameters after five years on continuous ambulatory peritoneal dialysis (CAPD): the effect of late peritonitis.

Functional stability of the peritoneum is essential for patients on long-term continuous ambulatory peritoneal dialysis (CAPD) treatment. Sixteen patients on CAPD treatment for at least 4 years were studied. Their mean age was 47 +/- 15 years, 5 were males, and none were diabetic. Residual creatinine clearance at the beginning was 2.1 +/- 2.6 mL/min. Once yearly since starting CAPD, we have evaluated their peritoneal ultrafiltration (UF) and diffusion capacities by calculating the peritoneal mass transfer coefficient (MTC, mL/min) for urea and creatinine. Patients were categorized so that we could distinguish the effect of peritonitis, betablockers, and hypertension. For all patients the average initial and final MTCs and UF values were not different. Early episodes of peritonitis (those occurring less than 36 months after starting CAPD) did not influence long-term function. However, late peritonitis (occurring greater than 36 months since initiation) induced a decrease in urea-MTC (22.3 +/- 6 to 15.8 +/- 3.9, p less than 0.05), creatinine-MTC (9.4 +/- 3.1 to 7.4 +/- 2.5, p less than 0.05), and a corresponding increase in UF (1.25 +/- 0.4 to 1.4 +/- 0.3, mL/min, p less than 0.05). Age, sex, betablockers and hypertension did not influence the peritoneal parameters followed. After 5 years on CAPD, functional stability of the peritoneum is evident, except for patients who suffer late episodes of peritonitis. We speculate that the peritoneum in patients who have been on long-term CAPD are more susceptible to injuries, such as peritonitis, and that this results in functional deterioration.

Adrenergic beta-Antagonists↗
PubMed1989

Insulin influence (used as an additive to dialysate) on the mitogenic-induced effect of the peritoneal effluent in CAPD patients.

Peritoneal effluent in CAPD patients is the result of the interaction between dialysate and patient through the peritoneal membrane. Among the factors transferred from the patient to dialysate are solutes capable of stimulating fibroblasts: Interleukin-I, Interferon-gamma, and other proteins. Insulin is a well known mitogenic coadjuvant able to act sinergistically with other mitogens in the stimulation of fibroblast proliferation under experimental conditions. Our objective has been to study the effect of insulin added to dialysate in vivo on the in vitro mitogen-induced capacity of the nocturnal peritoneal effluent in 8 diabetics. Two different samples were studied: basal and with in vivo added insulin with the patients' usual doses. A Swiss 3T3 line of mice fibroblasts was used for studies, adding 50 microliters of peritoneal effluent. To confirm in vivo potential mitogenic activity, we also added PDBu (Phorbol dibuturate), a well known mitogenic agent, to both samples. Furthermore, another growth factor, EGF (Epidermal growth factor), was also added to 5 other samples. Insulin addition to the CAPD bag transforms a non-mitogenic peritoneal effluent into a mitogenic one (mean: 4.4 times over basal). At the doses used in vivo there is no linear correlation between insulin dose and DNA synthesis (r: -0.28, NS). Both PDBu and EGF in vitro addition induced a remarkable increment in the mitogenic capacity of the peritoneal effluent. We conclude that insulin added to CAPD bags behaves as a remarkable mitogenic coadjuvant for mice fibroblasts. Consequently, its long-term and universal clinical use should be reconsidered.

Animals↗