PubMed Health⌕ Search

Biomedical subjects

J Rodriquez

Publications and source records attributed to J Rodriquez.

11 recordsLinked to original sources
PubMed2001

Penetrating esophageal injuries: multicenter study of the American Association for the Surgery of Trauma.

OBJECTIVE: The purpose of this study was to define the period of time after which delays in management incurred by investigations cause increased morbidity and mortality. The outcome study is intended to correlate time with death from esophageal causes, overall complications, esophageal related complications, and surgical intensive care unit length of stay. METHODS: This was a retrospective multicenter study involving 34 trauma centers in the United States, under the auspices of the American Association for the Surgery of Trauma Multi-institutional Trials Committee over a span of 10.5 years. Patients surviving to reach the operating room (OR) were divided into two groups: those that underwent diagnostic studies to identify their injuries (preoperative evaluation group) and those that went immediately to the OR (no preoperative evaluation group). Statistical methods included Fisher's exact test, Student's T test, and logistic regression analysis. RESULTS: The study involved 405 patients: 355 male patients (86.5%) and 50 female patients (13.5%). The mean Revised Trauma Score was 6.3, the mean Injury Severity Score was 28, and the mean time interval to the OR was 6.5 hours. There were associated injuries in 356 patients (88%), and an overall complication rate of 53.5%. Overall mortality was 78 of 405 (19%). Three hundred forty-six patients survived to reach the OR: 171 in the preoperative evaluation group and 175 in the no preoperative evaluation group. No statistically significant differences were noted in the two groups in the following parameters: number of patients, age, Injury Severity Score, admission blood pressure, anatomic location of injury (cervical or thoracic), surgical management (primary repair, resection and anastomosis, resection and diversion, flaps), number of associated injuries, and mortality. Average length of time to the OR was 13 hours in the preoperative evaluation group versus 1 hour in the no preoperative evaluation group (p < 0.001). Overall complications occurred in 134 in the preoperative evaluation group versus 87 in the no preoperative evaluation group (p < 0.001), and 74 (41%) esophageal related complications occurred in the preoperative evaluation group versus 32 (19%) in the no preoperative evaluation group (p = 0.003). Mean surgical intensive care unit length of stay was 11 days in the preoperative evaluation group versus 7 days in the no preoperative evaluation group (p = 0.012). Logistic regression analysis identified as independent risk factors for the development of esophageal related complications included time delays in preoperative evaluation (odds ratio, 3.13), American Association for the Surgery of Trauma Organ Injury Scale grade >2 (odds ratio, 2.62), and resection and diversion (odds ratio, 4.47). CONCLUSION: Esophageal injuries carry a high morbidity and mortality. Increased esophageal related morbidity occurs with the diagnostic workup and its inherent delay in operative repair of these injuries. For centers practicing selective management of penetrating neck injuries and transmediastinal gunshot wounds, rapid diagnosis and definitive repair should be made a high priority.

Adolescent↗
PubMed1995

In vitro fertilization and the effect of progesterone and 17 alpha-hydroxyprogesterone on acrosome reaction of mouse epididymal spermatozoa.

This study assessed the effect of progesterone and 17 alpha-hydroxyprogesterone (17 alpha-OH-progesterone) at concentrations of 0.01-10 micrograms/ml, on the acrosome reaction and in vitro fertilizing ability of mouse epididymal spermatozoa. Cumulus masses containing oocytes were cultured in Brinster's medium, to which were added capacitated epididymal spermatozoa which had been incubated in medium with various concentrations of progesterone or 17 alpha-OH-progesterone for 90 min. IVF success rate was assessed 20-24 h following insemination. Progesterone was found to increase the fertilization rate at the 1 microgram/ml and 10 microgram/ml concentrations while lower concentrations had no effect. However, 17 alpha-OH-progesterone failed to show any effect on fertilizing ability. Incubation of epididymal spermatozoa in medium containing 1 microgram/ml and 10 micrograms/ml progesterone significantly increased the acrosome reaction as monitored by a chlortetracycline fluorescence assay. 17 alpha-OH-progesterone, however, failed to show any effect on the acrosome reaction. The results suggest direct effects of progesterone, but not of 17 alpha-OH-progesterone, on fertilization and the acrosome reaction of mouse spermatozoa.

17-alpha-Hydroxyprogesterone↗
PubMed1993

Refinement of the rat crush-avulsion femoral artery injury model.

A model for studying arterial crush-avulsion injuries in the rat is described. The model uses a standardized crush of approximately 0.3 joules and a standardized avulsion. The crush is accomplished by gravity acceleration of a 400 g weight over a distance of 7.5 cm. The weight impacts an anvil over the artery distributing the force of the impact over a 10 mm length of the vessel. The avulsion is accomplished by a hemostat attached to a second, 120g weight. Vascular stasis for 90 sec after vessel repair in a 175-225 g rat will consistently result in an 80% anastomotic failure. The model allows evaluation of anticoagulant effects singly or in combination. Agents may be given either systemically by intravenous route or locally by intraarterial route.

Anastomosis, Surgical↗
PubMed1993

Quantitative bone gallium scintigraphy in osteomyelitis.

Gallium imaging offers many practical advantages over indium-111-labeled leukocyte imaging, and calculating quantitative ratios in addition to performing the routine bone-gallium images allows accurate and easy evaluation of patients with suspected osteomyelitis. To add objectivity and improve the accuracy and confidence in diagnosis of osteomyelitis, quantitative comparison of abnormalities seen on bone scans and gallium scans was performed. One hundred and ten adult patients with 126 sites of suspected osteomyelitis were evaluated and categorized by gallium-to-bone ratios, gallium-to-background ratios, and spatial incongruency of gallium and bone activity. Combined evaluation using these criteria gave a 70% sensitivity and 93% specificity for the diagnosis of osteomyelitis.

Adult↗
PubMed1990

The effect of mode of delivery on the perinatal outcome in fetuses with abdominal wall defects.

A descriptive study of 125 infants with abdominal wall defects was undertaken to determine the effect of mode of delivery on outcome. Fifty-six infants had gastroschisis and 69 had omphalocele. Overall, there were no differences between the omphalocele and the gastroschisis groups in either cesarean section rate (22% vs 26%) or prematurity rate (26% vs 30%). However, the omphalocele group had a significantly higher infant death rate (22% vs 7%, p less than 0.001), a significantly higher incidence of associated major congenital anomalies (29% vs 5%, p less than 0.001), and a higher incidence of long-term infant morbidity (14.5% vs 8.9%). Within either group there was no significant difference between vaginal and cesarean delivery regarding either infant mortality, acute or long-term infant outcome, or frequency of associated major anomalies. We conclude that vaginal delivery of infants with abdominal wall defects does not adversely affect infant outcome.

Abdominal Muscles↗
PubMed1988

Head trauma and nonsurvival--a sample survey.

A retrospective survivor study of 42 patients with severe brain and multisystem injury is presented. All patients were treated with vigorous trauma/neurosurgical techniques. Thirty-seven patients in this series had a Glasgow Coma Score of 3 at the initial examination, and none survived. Since all 37 patients at initial emergency room evaluation showed persistent apnea at 40-60 minutes after injury, a diagnosis of dead on arrival (DOA) might have been appropriate. Cost analysis shows that the direct cost for the 37 cases was $27,000 per patient, or $990,000 for the 37 patients with no survivors. A diagnosis of DOA would have been $200 per patient. Many implications can be derived from these figures.

Adolescent↗
PubMed1982

[Pharyngolaryngectomy without nasogastric feeding tube nor tracheal cannula (author's transl)].

Thirty three patients have been operated with total laryngectomy (LT) or pharyngolaryngectomy (PLT) with or without Zadical neck dissection, without nasogastric feeding to be and in five cases without tracheal cannula (but connection of a large tracheostomy). The authors demonstrated that there is no increasement of pharyngeal fistua. The beginning of oral alimentation has been made between the 4th and the 6th postoperative day. Such a procedure is more comfortable for the patients and decrease the hospitalisation duration.

Adult↗
PubMed1979

Progesterone binding by human endometrial tissue during the proliferative and secretory phases of the menstrual cycle and by hyperplastic and carcinomatous endometrium.

Cytosol receptors for progesterone were assayed in human endometrial tissue during the proliferative and secretory phases of the menstrual cycle and in the hyperplastic and carcinomatous endometrium. The assays were performed utilizing a technique involving prior treatment of the cytosol extract with dextran-coated charcoal to remove endogenous progesterone. The results showed that the progesterone receptor activity was higher during the later proliferative and early secretory phases of the menstrual cycle. Hyperplastic and carcinomatous endometrium also contained specific cytosol receptor for progesterone, and the binding activity of the hyperplastic endometria and endometrial polyps was comparable to that found during the later proliferative phase of the menstrual cycle. No apparent correlation between the progesterone receptor level and the morphologic degree of differentiation in Grades 1 and 2 adenocarcinomas of the endometrium was observed.

Adenocarcinoma↗