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Biomedical subjects

J Silvestre

Publications and source records attributed to J Silvestre.

At least 19 recordsLinked to original sources
PubMed2001

Relation between the bowel electromyogram and the intestinal pressure wave. An experimental study in dogs.

OBJECTIVE: A linear regression study is made of the parameters identifying the electrical activity of the small bowel, with the aim of determining those variables most closely related to the type I pressure waves. PATIENTS AND METHODS: A computer system was used for the simultaneous and real time acquisition of the manometric activity (using microballoons implanted in the bowel mucosa) and electromyogram of the intestine (employing bipolar electrodes implanted in the intestinal serosa) in dogs. RESULTS: Of the electromyogram intestinal parameters studied, those determining signal energy (root mean square voltage and energy) yielded the highest correlation coefficients (0.71 +/- 0.08 in the jejunum and 0.78 +/- 0.06 in the duodenum) to bowel pressure. Peak-to-peak voltage also shows good correlation, though to a lesser degree. The rest of the parameters studied, such as those that measure the duration of the action potential or its number of peaks, yielded poor correlations to pressure. CONCLUSIONS: It is concluded that the energy of the intestinal electromyogram represents the mechanical activity of the small bowel, reflecting intestinal motility, and that the recording of this parameter is not subjected to subjective cutoff values or threshold levels. On the other hand, and unlike in the case of manometric recordings, the signal obtained is free of background interference and noise.

Animals↗
PubMed1998

Subtypes of ataques de nervios: the influence of coexisting psychiatric diagnosis.

The current study assesses the relationship between presenting symptomatology of the self-labeled Hispanic popular diagnosis of ataques de nervios and the specific co-morbid psychiatric diagnoses. Hispanic subjects seeking treatment at an anxiety disorders clinic (n = 156) were assessed with a specially designed self-report instrument for both traditional ataque de nervios and panic symptoms, and with structured or semistructured psychiatric interviews for Axis-I disorders. This report focuses on 102 subjects with ataque de nervios who also met criteria for panic disorder, other anxiety disorders, or an affective disorder. Distinct ataque symptom patterns correlated with co-existing panic disorder, affective disorders, or other anxiety disorders. Individuals with both ataque and panic disorder reported the most asphyxia, fear of dying, and increased fear during their ataques. People with ataques who also met criteria for affective disorder reported the most anger, screaming, becoming aggressive, and breaking things during ataques. Ataque positive subjects with other anxiety disorders were less salient for both panic-like and emotional-anger symptoms. The findings suggest that (a) ataque de nervios is a popular label referring to several distinct patterns of loss of emotional control, (b) the type of loss of emotional control is influenced by the associated psychiatric disorder, and (c) ataque symptom patterns may be a useful clinical marker for detecting psychiatric disorders. Further study is needed to examine the relationship between ataque de nervios and psychiatric disorders, as well as the relationship to cultural, demographic, environmental, and personality factors.

Adult↗
PubMed1998

Multisite pacing as a supplemental treatment of congestive heart failure: preliminary results of the Medtronic Inc. InSync Study.

This report describes the initial results of the "InSync" study, a European and Canadian multicenter trial that examines the safety and efficacy of a multisite pacemaker (Medtronic InSync) and of left ventricular pacing leads (Medtronic 2187 and 2188) implanted via a cardiac vein as a supplemental treatment of refractory congestive heart failure. Over a 10-month period, the system was implanted successfully in 68 of the 81 (84%) patients who had been enrolled in the study. The 68 patients were, on average, 66 +/- 10 years old, had a mean left ventricular ejection fraction (LVEF) = 21% +/- 9%, and 63% were in NYHA functional Class III and 37% were in Class IV. No system implant related complication occurred. During follow-up, 7 of 10 patients who exited the study had died, 4 suddenly. There was a clinical benefit among surviving patients, which was corroborated by a significant improvement in NYHA functional class and in the Minnesota Living with Heart Failure Quality of Life Questionnaire Score (MLS) and by a longer distance covered during a 6-minute walk test. This clinical improvement was associated with a significant narrowing of the paced QRS complex during biventricular pacing, a significant decrease in the interventricular mechanical delay, and a trend towards an increase in the duration of ventricular filling. These encouraging preliminary results confirm the feasibility and reliability of this new multisite pacing system in the management of dilated cardiomyopathy and support the continuation of further evaluations of this complementary treatment of refractory congestive heart failure.

Aged↗
PubMed1995

Delayed papillary muscle rupture following mild chest trauma.

A case of delayed papillary muscle rupture is reported, which developed 24 hours following a mild chest trauma. Transthoracic echocardiography established the diagnosis; immediate mitral valve replacement was carried out. The postoperative course was uneventful.

Accidental Falls↗
PubMed1995

Situs inversus and myocardial revascularization. Case report.

This report describes an internal mammary artery by-pass grafting to the anterior descending coronary artery in a man with an unstable postinfarction angor pectoris and a "situs inversus totalis" condition. The association of "situs inversus totalis" and atherosclerotic coronary artery disease has the same incidence as in normal people. To the authors' knowledge, this is the second case in medical literature of coronary artery by-pass surgery with internal mammary artery graft in a patient with "situs inversus totalis".

Adult↗
PubMed1994

Ataque de nervios and panic disorder.

OBJECTIVE: Ataque de nervios ("attack of nerves") is an illness category used frequently by Hispanic individuals to describe one or more particular symptom complexes. A review of the literature on ataque suggested some overlap with panic disorder. This study investigated the overlap with panic disorder as well as other DSM-III-R axis I disorders. METHOD: Hispanic subjects seeking treatment at an anxiety disorders clinic (N = 156) were assessed with a specially designed questionnaire for self-report of ataque de nervios and panic symptoms and with structured or semistructured psychiatric interviews for axis I disorders. RESULTS: Seventy percent of the subjects reported at least one ataque de nervios; 80% of these were female, whereas 57% of the group without these attacks were female. There were no differences in DSM-III-R diagnoses between the groups with and without ataque de nervios. Ataque was frequently associated with one or more anxiety and affective disorders, including panic disorder, generalized anxiety disorder, recurrent major depression, and anxiety not otherwise specified. Of the 45 subjects with both ataque de nervios and primary panic disorder, 80% appeared to have labeled panic disorder as ataque. Ataque de nervios was associated with panic symptoms even in subjects without panic disorder, but the self-reporting of ataque conveyed additional clinical information about the subjects with panic disorder. Ataque de nervios was similar in frequency and symptoms among subjects of Dominican and Puerto Rican origin. CONCLUSIONS: Ataque de nervios overlaps with panic disorder but is a more inclusive construct. Further study of its interrelation with axis I disorders is needed.

Adult↗
PubMed1994

[Cardiovascular surgery in Spain in 1992. The Registry of Operations of the Spanish Society of Cardiovascular Surgery (SECCV)].

The Spanish Society of Cardiovascular Surgery Registry of 1992 includes data from 41 centers. Within this year a total of 24,127 patients were operated on, with an average of 588 operations/center. Twelve thousand twenty-two of these were cardiac operations under extracorporeal circulation, with an average of 300 cases/hospital. The average of cardiac surgeons/hospital was 5.9 and the average of open heart operations/surgeon was 50. For the first time, the number of coronary bypass surgeries was superior to that of valvular procedures (5,049 vs 4,951). In the coronary bypass patients the average of grafts/patient was 2.43. The number of valvular prostheses implanted was 5,526 and 81% of these were mechanical. The number of patients operated on for congenital cardiac defects was 2,251 (1,278 open heart surgeries and 973 closed). The global mortality in the patients operated on under extracorporeal circulation was 7.6% (7.0% in valvular, 7.9% in congenital and 5.4% in coronary bypass). There were 6,054 patients subjected to surgery for peripheral vascular disease.

Cardiac Surgical Procedures↗
PubMed1993

Subacute cardiac rupture: repair with a sutureless technique.

Thirteen patients with ages between 53 and 74 years had development of free wall left ventricular rupture after a myocardial infarction (mean interval, 3.8 days). All patients showed clinical signs of cardiac tamponade. Diagnosis was established by bedside multiple pressure monitoring and echocardiography, which showed pericardial effusion with compression of the right ventricle. Cardiac catheterization was not performed. A new surgical technique was employed for the repair. After the pericardium was opened and cardiac tamponade was relieved, the myocardial tear was identified. A Teflon patch was applied over the area and glued to the heart surface with a surgical glue (cyanoacrylate). Cardiopulmonary bypass was not used except in a patient with a posterior tear. The method was consistently effective in controlling bleeding from the myocardial tear. All patients survived the operation and were discharged from the hospital a mean of 15 days after the operation. Follow-up extending up to 5 years (mean, 26 months) shows a 100% survival, 11 asymptomatic patients, and 2 patients with mild exertional angina. The technique is a simple, effective, and safe method for repair of subacute cardiac rupture and obviates the need for suturing on an infarcted ventricle.

Aged↗
PubMed1992

[Left atrial thrombus. Its evolution with oral anticoagulation].

UNLABELLED: Left ventricular thrombi were found in 25 patients by two-dimensional echocardiography. All patients were in atrial fibrillation, 16 had mitral or mitroaortic valve diseases and nine mitral or mitroaortic bioprosthetic valves. Nine patients (36%) had history of arterial embolism. At diagnostic time, oral anticoagulation with coumadin was instaured in all the patients. Periodic clinic and echocardiography follow-up was performed. Left atrial thrombi either disappeared (18 patients [72%]) or reduced their size (one patient). Six patients with mitral stenosis were considered as candidates to percutaneous mitral valvuloplasty, which was performed in 4 patients whose thrombi disappeared with anticoagulation therapy in 6 months. During the follow-up one patient had cerebral embolism without sequelae. CONCLUSIONS: 1st. Patients with left atrial thrombi have high risk for arterial embolism. 2nd. Left atrial thrombi disappear in a high proportion after prescribing oral anticoagulation, which has some important therapeutic implications.

Administration, Oral↗
PubMed1991

[Left ventricular perforation following percutaneous mitral valvuloplasty. Its emergency surgical correction in situ. Apropos a case].

Percutaneous mitral valvuloplasty is actually accepted as alternative to surgery for treatment of rheumatic mitral stenosis, although today it is not still free from troublesome complications like ventricular perforation. We present here a patient in which was performed a percutaneous mitral valvuloplasty and that developed a left ventricular perforation at the end of the procedure, with hyperacute cardiac tamponade, requiring an in situ surgical salvagement on an emergency basis, performing a successful repair of the ventricular rupture in the own catheterization laboratory.

Balloon Occlusion↗
PubMed1986

Haemodynamic findings in experimental right ventricular ischaemia after right coronary arterial ligation.

Acute ischaemia limited to the free wall of the right ventricle was produced by right coronary arterial ligation (RCAL) in 20 dogs. Contrast M-mode and cross-sectional echocardiography was performed in 7 cases to investigate the presence of tricuspid insufficiency. The haemodynamic findings obtained with an open pericardium at 15 to 30 min showed increases in right (1.2 +/- 0.5 to 2.7 +/- 0.7 mmHg, P less than 0.01) and left (5.0 +/- 0.8 to 6.6 +/- 0.9 mmHg, P less than 0.05) ventricular end-diastolic pressures, and decreases in heart rate (139 +/- 4.9 to 119 +/- 5.1 bpm, P less than 0.01), cardiac index (106 +/- 6.6 to 81 +/- 7.3 ml min-1 kg-1, P less than 0.01), stroke index (79 +/- 6 to 72 +/- 8 ml X 100 beat-1 kg-1, P less than 0.02), right (23.8 +/- 1.5 to 19.4 +/- 1.5 mmHg, P less than 0.01) and left (109 +/- 7.2 to 95 +/- 8.2 mmHg, P less than 0.05) ventricular systolic pressures and right ventricular stroke work index (18.3 +/- 2.4 to 11.4 +/- 1.8 g m kg-1, P less than 0.01). In 6 of 15 cases the 'y' descent became deeper than the 'x' descent in right atrial pressure (RAP). Tricuspid insufficiency grade I-II/IV was present in 3 of 7 cases, 2 of them with a 'y' greater than 'x' in RAP. Right ventricular mechanical alternans, probably secondary to a decrease in contractility, appeared in 10 of 20 cases after RCAL.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1984

Identification of blood in the pericardial cavity in dogs by two-dimensional echocardiography.

The echocardiographic characteristics of hemopericardium with and without thrombus formation were investigated in 10 dogs and compared with that of saline solution injected into the pericardial cavity. Injection of 80 to 120 ml of saline solution produced an echolucent space between both pericardial layers and was considered as the control image in each dog for comparison with hemopericardium. Injection of heparinized blood filled the pericardial cavity with irregular echoes of variable acoustical impedence. High-density echoes of irregular distribution were observed in 3 dogs, in 5 dogs the echoes were of low acoustical density and in 2 dogs blood echoes were present but scarcely visible. Injection of clotted blood in 9 dogs (adding 20 mg of protamin sulphate and 8 mg of aminocaproic acid) produced echoes of high acoustical density easily identified in the 2-dimensional echocardiographic images. In 4 dogs attenuation and damping controls were increased to the point where myocardial echoes disappeared, while intrapericardial echoes were still visible. Thus, hemopericardium with or without thrombus formation may be identified by 2-dimensional echocardiography and differentiated from other types of pericardial effusion of lower acoustical density. Echogenicity of fluid blood in the pericardial cavity may be related to blood stasis.

Animals↗
PubMed1984

[Myocardial tomoscintigraphy with technetium pyrophosphate in the diagnosis of recent infarction].

Technetium pyrophosphate myocardial scintigraphy has become, together with Thallium scintigraphy, a common diagnostic aid in recent myocardial infarction. However, some cases with moderate diffuse fixation (2+ diffuse in Parkey's classification) are considered equivocal results by many workers. We tried to assess the value of emission tomoscintigraphy in classifying these border-line cases. This non-invasive investigation requires sophisticated equipment, including a rotating gamma camera coupled to a computer. The computer reconstructs tomographic images in the three planes (frontal, sagittal, transverse) at 6 mm intervals. After analysis of 34 coronary patients using classical clinical criteria, standard and tomographic scintigraphy were performed and the results interpreted by a double blind procedure. The following conclusions were drawn: Interpretation of the results of tomography was more reproducible than that of standard scintigraphy (91 p. 100 compared with 79 p. 100). The sensitivity of detection of myocardial infarction was higher (96 p. 100 compared to 80 p. 100) without any loss of specificity (preliminary study in 15 non-coronary patients); this improvement is due to the elimination of the "equivocal" cases observed on standard scintigraphy. The infarcted area was easier to determine as the interpretation was more reproducible. The estimation of the size of the infarcted area and the detection of rudimentary infarcts did not seem to be improved by emission tomography. Our criteria of positivity for the tomographic images were : at least 2+ fixation (significant but less intense than that of the sternum); fixation visible in at least 2 different tomographic planes (e.g. sagittal and frontal); fixation visible on at least 2 consecutive images in each plane.

Adult↗
PubMedDate not supplied

[Percutaneous transluminal angioplasty in aortic coarctation in young adults].

The results of percutaneous balloon angioplasty in 9 cases of adult aortic coarctation are described. One case was associated with bicuspid aortic valve and another with organic aortic stenosis. Two of them were female, and the rest were male. The mean age range between 15-26 years (19 +/- 4.2). Pressure gradients fell from 59 +/- 13 mmHg to 15 +/- 11 mmHg postdilatation (p less than 0.0001), and the internal lumen diameters increase from 5 +/- 3 mm up to 13 +/- 2 mm (p less than 0.0001). In one case an intimal dissection appears as complication. At consequence of these results, the percutaneous balloon angioplasty seems to be a good therapeutic procedure in the adult aortic coarctation.

Adolescent↗