PubMed Health⌕ Search

Biomedical subjects

L Miranda

Publications and source records attributed to L Miranda.

45 records · Page 3Linked to original sources
PubMed1977

Use of the bifurcated needle for BCG vaccination of newborns.

The bifurcated needle vaccination method used successfully against smallpox is a relatively simple technique that can be administered by personnel with only basic preparation and a minimum of training. This fact suggests that it could prove useful in campaigns of BCG vaccination against tuberculosis--especially for vaccination of newborns. With this end in mind, two studies were carried out in Santiago, Chile, to examine previously reported difficulties with the method and to assess its potential as an alternative to the best current method, that of intradermal inoculation. These studies indicated that previously reported variations in the results achieved by different vaccinators could be markedly reduced. However, they also found that the bifurcated needle method did not cause a sufficiently large dose of vaccine to enter the subject--even when fifteen needle strokes and a highly concentrated vaccine (160 mg per ml) were employed. It was thus concluded that although modification of the needle or other changes might ultimately yield satisfactory results, the bifurcated needle technique cannot yet be recommended for BCG vaccination of newborns.

BCG Vaccine↗
PubMedDate not supplied

Prevention of congenital dislocation of the hip in the newborn.

Routine examination and early treatment of any instability in the hips of newborns has recently been called into question after a period of universal agreement. The hips of 49,937 neonates were prospectively studied by a general hip screening. Every unstable hip--449 in 317 children--was immediately treated with a Von Rosen splint for a 3-month-period. Overall, satisfactory reduction of the incidence of established congenital dislocation of the hip (CDH) was achieved. Risk factors leading to unstable hips (sex, first birth, and breech birth) and the development of CDH (time of stabilization) were considered.

Diagnostic Errors↗
PubMedDate not supplied

[Neurocysticercosis. An emergent disease].

Neurocysticerosis is an affection of the central nervous system by the larvae of the Taenia solium. Although its diagnosis in our country is exceptional, in recent years a notable increase in the number of cases diagnosed has been observed, due to the phenomenon of immigration from countries where the disease is endemic. The most frequent form of presentation of neurocysticercosis is seizures, followed by headache. To diagnose it we must evaluate the epidemiological data, the clinical record and confirm this through neuroimage and immunological studies. The treatment selected should be pharmacological, principally with albendazole, and surgery reserved for cases where the former fails. Hygienic measures and the treatment of patients with teniasis are of great importance. Neurocysticerosis has ceased to be an exceptional diagnosis and given the foreseeable increase of its incidence in our milieu, health professionals must understand this disease and include it at higher levels of the algorithms of differential diagnosis.

Diagnosis, Differential↗
PubMedDate not supplied

[Septic thrombophlebitis of the portal vein (pylephlebitis): diagnosis and management of three cases].

BACKGROUND: Pylephlebitis is thrombophlebitis of the portal vein and/or of its branches; it is acute and generally arises as a complication of inflammatory intra-abdominal processes or of surgical interventions in patients with blood discrasies. As its clinical picture is fairly non-specific, radiological findings, while not pathognomonic, are of great use in early diagnosis and improved vital prognosis of these patients. The aims of this study are to review the pathophysiology of this entity and its clinical and radiological presentation, which allow for early clinical suspicion. CLINICAL CASES: Three cases of pylephlebitis are presented, two of them post-surgical, in which the only common clinical data for suspicion were the febricula and leucocytosis. Diagnosis was obtained from the finding of helicoidal computer tomography with IV contrast - Somaton Siemens - and abdominal echography - Ellegra Siemens - carried out on the three. The result of these tests was decisive for an early diagnosis, efficient treatment and satisfactory evolution in the three cases. DISCUSSION: We wish to emphasize the importance of clinical suspicion and early radiology for an early diagnosis of this entity, which make it possible to establish an efficient treatment.

Adult↗
PubMedDate not supplied

[Hemolytic anemia in the malfunction of a mitral bioprosthesis].

Valvular cardiac prosthesis have dramatically altered the prognosis of patients with valvular cardiac disease; however, they are not free of complications. Prosthesis disfunction and problems related to anticoagulation are the more common, but hemolytic anemia should also be considered. In this case, hemolytic anemia appears as the major complication of a mitral bioprosthesis; the decision concerning the presentation of this case report rests upon its rarity and peculiar circumstances of appearance. A brief revision of the diagnostic work-up is also made.

Anemia, Hemolytic↗