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J R Rodríguez

Publications and source records attributed to J R Rodríguez.

68 records · Page 4Linked to original sources
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[The phenomenon of abuse of aged Puerto Ricans].

The present study is the first one to our knowledge that tries to give a panoramic view and explore the problem of Elderly Abuse in Puerto Rico. A retrospective statistical analysis of frequencies of cases by sex gender, age strata and region has been obtained showing an increasing tendency of cases. We conclude that the phenomena of abuse in the Puerto Rican Elderly population is one that requires rapid interventions with emphasis in the prevention component.

Age Factors↗
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[Disseminated encephalic cryptococcosis as a form of presentation of idiopathic T-CD4 lymphocytopenia].

INTRODUCTION: The term idiopathic T-CD4 lymphocytopenia is used to describe a new syndrome, defined as reduced T-CD4 lymphocytes in persons with no evidence of HIV infection or other causes which would explain the immunosuppression (secondary to neoplasties, immunosuppressive treatment, hereditary immunodeficiencies, infections, etc.). The reduced number of T-CD4 lymphocytes leads to deterioration in cellular immunity and therefore this leads to a predisposition to develop tumors and opportunist infections in patients with such defects. CLINICAL CASE: We describe a case of depletion of T-CD4 lymphocytes, associated with disseminated encephalic cryptococcosis (multiple cortical, capsulo-ganglionar, thalamic and cerebellar cryptococcomas) in a patient with no evidence of HIV infection. The case we present fulfilled diagnostic criteria for idiopathic T-CD4 lymphocytopenia, a clinical condition seldom described in this country. We discuss the pathogenic mechanisms of cryptococcosis, the different varieties of Cryptococcus neoformans and their different roles as the cause of opportunist infections in humans. CONCLUSIONS: In view of the neurotrophism of this fungus, the neurological signs and symptoms should make one suspect the presence of Cryptococcus neoformans infection in non-HIV carriers with cellular immunity defects such as those present in idiopathic T-CD4 lymphocytopenia.

Adult↗
PubMedDate not supplied

[Relationship between the 1993 Daugirdas Kt/V method and other methods to calculate the dialysis dose].

INTRODUCTION: There are several shortcut formulas to calculate Kt/V, the most widely used because of its simplicity is the logarithmic formula proposed by Lowrie in 1983. The DOQI report recommends use of the formula proposed by Daugirdas's in 1993 to estimate the Kt/V, it must be > or = 1.2. The aim of the present work was to analyse the concordance between the second generation Daugirdas's formula and the other shortcut formulas. MATERIAL AND METHODS: In 208 hemodialysis sessions performed on 61 patients, Kt/V was estimated by thirteen formulas: 10 single-pool modeling and three double-pool modeling. RESULTS: The Kt/V values obtained by Daugirdas's formula was different from those obtained with the other single-pool based formulas (p < 0.01). When the dialysis sessions were classified in 4 groups according to the Kt/V values calculated by Daugirdas's formula, most of the single-pool formulas gave Kt/V values statistically different from those given by Daugirda's formula in all ranges examined. The concordance among Kt/V calculated by every one of the single-pool formulas and Daugirdas's formula was variable. The highest agreement was with Keshaviah's and Lowrie's 1992 formulas and the lowest with Calzavare's and Lowrie's 1983 formulas. The linear multivariate analysis showed that the two factors which influenced the concordance were the Kt/V value obtained by the Daugirdas's formula, and the quotient between the postdialysis body weight and the ultrafiltration rate. Despite the weak concordance with Daugirdas's formula, the Kt/V obtained by Lowrie's 1983 formula and the urea reduction ratio (URR) are still useful tools to monitor the adequacy of dialysis: a Kt/V > 1.065 calculated by the Lowrie's 1983 formula and a PRV > 65% are equivalent to a Kt/V > or = 1.2 calculated by Daugirdas's formula. CONCLUSIONS: The shortcut formulas used to calculate Kt/V give different results with high inter-method variability. When Kt/V is reported it is absolutely necessary to indicate the formula used to calculate it. The Kt/V obtained by Lowrie's 1983 formula and the URR are useful tools to monitor dialysis adequacy.

Adult↗
PubMedDate not supplied

[Relationship between ionic dialysance and urea clearance].

INTRODUCTION: Ionic dialysance is a method of continuous on-line monitoring of delivered dialysis without blood sampling. To compare the results obtained by ionic dialysance and those obtained by the traditional measurements of the dialysis dose, it is necessary to know the relationship between the ionic dialysance and urea clearance. MATERIAL AND METHODS: Ionic dialysance and the urea clearance were determined in 18 patients (13 dialyzed with cuprophan and 5 patients with AN69). Urea clearance was measured by 6 different methods: urea clearance in whole blood calculated with the arteriovenous difference in the urea concentration rates and the arterial flow measured by the rolling pump (KBAVb) or by ultrasounds (KBAVu); urea clearance in whole blood measured by the urea concentration in the dialysate (KBD); urea blood water clearance measured by the arteriovenous difference in the concentration rates using the arterial flow measured by the roller pump (KwBAVb) or by ultrasounds (KwBAVu) and urea blood water clearance measured by the urea concentration in dialysate (KwBD). RESULTS: The mean arterial flow measured by the roller pump was 314.4 +/- 16.2 ml/min and 275.1 +/- 13.8 ml/min when measured by ultrasounds (p < 0.001). The data of ionic dialysance and urea clearances were as follow (ml/min): ionic dialysance 185.6 +/- 11.7; KBAVb 245.7 +/- 15.7; KBAVu 215.4 +/- 13.2; KBD 231.6 +/- 13.1; KwBAVb 218.1 +/- 14; KwBAVu 191.2 +/- 11.8; KwBD 183.1 +/- 11.7. The absolute difference of ionic dialysance with the KwBAVu was 8.4 +/- 6 ml/min (range between -17.8 and 11.5 ml) and with the KwBD was 7.6 +/- 5.4 ml (range between -12.9 and 21.4 ml). CONCLUSIONS: There was a relationship between ionic dialysance and urea blood water clearance. The best concordance was obtained when the clearance was calculated with the urea concentration of dialysate, or with the arteriovenous difference of the urea concentration rates and the arterial blood flow measured by ultrasounds.

Adult↗
PubMedDate not supplied

[Estimate of the dialysis dose using ionic dialysance].

UNLABELLED: The Diascan equipment (Hospal) measures ionic dialysance from which it derives the Kt/V. It is automatic, does not need blood samples and displays the results in real time. The aim of the present study was to compare the Diascan Kt/V with the Kt/V obtained with four simple formulas: two based on a single pool model of urea kinetics (Lowrie 1983 and Daugirdas 1993) and the other based on the two pool model (Maduell formulation applied to Lowrie Kt/V and that proposed by Daugirdas 1995). We have analyzed the inter-method variability, the degree of relationship among the different procedures for Kt/V calculation and the intra-individual variability. The intermethod variability between Kt/V Diascan and Kt/V calculated by the four simple formulas were studied in one hemodialysis session in 19 patients. The Kt/V Diascan was statistically different from that calculated by the four formulas (1,021 +/- 0.140 Diascan vs 1,147 +/- 0.124 for Lowrie-83; vs 1,373 +/- 0.164 for Daugirdas-93; vs 0.963 +/- 0.105 for Maduell and vs 1,173 +/- 0.143 for Daugirdas-95, p < 0.01). The lowest inter-method variability was obtained with the Maduell's Kt/V (relative difference 9%) but even in this case 37% of patients had a variability above 10%. The correlation coefficient was not high enough to allow an estimation of the different Kt/V measurements from the Diascan Kt/V by a regression equation. To study the individual relationship between the Diascan Kt/V and the Kt/V calculated by the four formulations, we have determined the Kt/V every 30 minutes in one hemodialysis session in 30 patients. In all patients we observed a good relationship between the Diascan Kt/V and the other four (correlation coefficient of 0.9952 for Lowrie-83, 0.9976 for Daugirdas-93, 0.9961 for Maduell and 0.9971 for Daugirdas-95); with these correlation coefficientes it was possible to derive regression equations and to obtain an estimation of the four Kt/V's from the Diascan Kt/V. To study the individual variability of each procedure used in the Kt/V calculations we determined the coefficient of variation of the different methods in 5 consecutive hemodialysis sessions performed under identical conditions in 19 patients. The coefficient of variation was 3.7 +/- 1.8% for the Diascan Kt/V; 6.0 +/- 2.8 for the Lowrie-83 Kt/V; 5.8 +/- 2.4 for the Daugirdas-93 Kt/V; 6.5 +/- 2.6% for the Maduell Kt/V; and 5.7 +/- 2.2% for the Daugirdas-95 Kt/V (p < 0.01 between the Diascan Kt/V and the other four). CONCLUSIONS: Although the Diascan Kt/V was statistically different from the other four Kt/V's calculated by the usual formulas, the Diascan Kt/V has an excellent correlation with all of them and showed a lower intra-individual variability. It is possible to obtain an estimation of the calculated Kt/V for each patient by linear regression equation.

Electrophysiology↗
PubMedDate not supplied

[Correction of facial disharmony using mandibular bone grafts].

The case of a patient affected by maxillary retrognathism associated with mandibular prognathism, is described. The patient was operated in our service after being studied in the multidisciplinary clinics. It is determined to use a mandibular bone graft in order to make use of the same surgical area, avoiding, in that way, maxillary retrodisplacement and additional aggressions to the patients, which should be caused by the act of taking a fragment of the crest of the iliac bone. The patient presents a wholly favorable evolution.

Adult↗
PubMedDate not supplied

[Indicators of anxiety and depression in subjects with different kinds of diet: vegetarians and omnivores].

The following study, one of the first done in Puerto Rico, investigate the different kinds of diet and the level of anxiety and depression that the subjects present. The sample consists of 80 subjects between 25 and 70 years age divided into two main groups (vegetarian versus no vegetarian) depending their diet consumption. The basic findings in the three psychological tests given (IDARE-1, IDARE-2 and CES-D) to the subjects demonstrate significant differences in anxiety and depression between groups. More anxiety and depression where reported in the no vegetarian groups in comparison with the vegetarian groups. In addition, diet analysis found more nutritional antioxidant agents levels in the vegetarian group in comparison with the no-vegetarian group.

Adult↗