Biomedical subjects

M Andresen

Publications and source records attributed to M Andresen.

At least 19 recordsLinked to original sources

PubMed2001

[Study of cytokines kinetics in severe sepsis and its relationship with mortality and score of organic dysfunction].

BACKGROUND: The Infectious Systemic Inflammatory Response syndrome and multiple organic dysfunction have common physiopathological mechanisms. Multiple organic dysfunction can be assessed using severity scores. AIM: To relate cytokine kinetics with a multiple organic dysfunction score during sepsis. MATERIAL AND METHODS: Tumor necrosis factor alpha (TNF alpha) and interleukin 6 (IL6) kinetics were studied in 25 patients with severe sepsis with less than 48 h of evolution and interleukin 1 beta (IL beta) kinetics was studied in 13 patients. Measurements were made at 0, 12, 24 and 48 hours after admission to the study, using an ELISA technique. These parameters were correlated with the Marshall multiple organic dysfunction score and survival. RESULTS: Mean age of study subjects was 70 years, the APACHE II score was 16.9 +/- 6 and the Marshall score was 6.8 +/- 3.6. Sepsis was of pulmonary origin in 56% of patients and intra abdominal in 32%. Mortality was 36%. TNF alpha increased during the study period (24.1 pg/ml initially and 37.8 pg/ml at 24 hours, with a slight posterior reduction, p < 0.02). These levels had no association with mortality or organic dysfunction. IL6 remained elevated during the first hours and had a tendency to decrease thereafter. Decreased patients had higher values than survivors (306 pg/ml and 55.4 pg/ml respectively, p = 0.011). Its values were tightly correlated with Marshall score, with the number of failing organs, with the presence of shock and with probability of dying during hospitalization. IL1 beta remained low and was not associated with clinical parameters. CONCLUSIONS: There is a tight correlation between the elevation of IL6 and the severity of the Systemic Inflammatory Response and mortality in these patients with sepsis.

APACHE↗

PubMed2000

Academic progress of children who attended a preschool for abused children: a follow-up of the keepsafe project.

OBJECTIVE: This study was undertaken to assess academic progress of children 1 to 5 years after graduating from the C. Henry Kempe Center's Therapeutic Preschool Day Treatment Program. METHOD: Information was gathered through chart review; telephone surveys of care providers, relatives, and social service workers; as well questionnaires on all children who attended the therapeutic preschool day treatment program between 1984 and 1989, including the 24 children reported on by Oates, Gray, Schweitzer, Kempe, and Harmon, 1995. RESULTS: Classroom placement was determined for 27 of the 44 graduates (61.4%), 14 of whom (51.9%) were in a regular classroom, 10 (37.0%) in special education, two (7.4%) in residential treatment, and one (3.7%) was receiving home schooling. Twenty-two of the 27 children (81.5%) improved or remained in the same grade and type of classroom as they had been staffed into at the time of their graduation from the preschool day treatment program. Factors thought to affect stability of classroom placement were studied, of which frequency of family moves was the only significant variable. Its significance was in the direction opposite to that expected. The most effective method of locating families was to contact the Department of Social Services who provided information used to find 60% of them. CONCLUSIONS: Intervention in a therapeutic preschool day treatment program was found to be beneficial, as it enabled most of the children to progress appropriately in public school.

Achievement↗

PubMed2000

West Nile encephalitis.

WNV encephalitis in horses, previously reported in Africa, Asia, and Europe, occurred for the first time in the Western Hemisphere in 1999. The causative agent, WNV, is a flavivirus maintained in nature by a bird-mosquito cycle. The disease in horses is manifested primarily by ataxia of variable severity. Outbreaks of encephalitis may have a case fatality rate in excess of 40%, although this virus infection is inapparent in some horses. Early evidence indicates that WNV has overwintered in the northeastern United States and poses a threat for future disease occurrences in horses. No vaccine is available to protect against WNV infection in horses; disease control is predicated on mosquito abatement.

Animals↗

PubMed2000

Human papillomavirus type 16 E7-regulated genes: regulation of S100P and ADP/ATP carrier protein genes identified by differential-display technology.

Human papillomavirus type 16 (HPV-16) is the dominant risk factor for the development of cervical cancer. The virus encodes three oncoproteins, of which the E7 oncoprotein is the major protein involved in cell immortalization and transformation. E7 is a multi-functional protein. It binds the retinoblastoma tumour-suppressor protein (pRb), which regulates progression through the G(1) restriction point in the cell cycle. The E7 protein interacts with transcription-regulatory proteins such as the TATA box-binding protein and with proteins of the AP1 transcription factor family. To identify additional proteins regulated by E7, differential-display PCR was used to identify differentially expressed mRNAs in cells containing an inducible E7 protein. It is reported that E7 expression leads to regulation of the genes encoding the calcium-binding protein S100P and the mitochondrial ADP/ATP carrier protein. These data identify new functions of the E7 protein and thus expand the number of routes by which HPV-16 influences cell growth control, although the function of S100P has still to be elucidated.

Calcium-Binding Proteins↗

PubMed2000

[Research articles].

Since 1973, Revista Médica de Chile has classified biomedical and clinical prospective research papers in a Section named "Research Articles", while purely clinical and retrospective studies were classified into another Section, named "Clinical Experiences". This distinction seems no longer necessary, because both types of manuscripts are subjected to a uniform external peer-review system and their intrinsic quality is not a distinctive feature. Furthermore, the name of Sections where similar papers are classified by the major general clinical medicine journals is clearly non-uniform. Therefore, "Research Articles" and "Clinical Experiences" will from now on be included into a single Section: "Research Articles".

Periodicals as Topic↗

PubMed2000

[Authorship in manuscripts published in biomedical journals].

Multiauthorship shows an increasing trend in biomedical and other scientific journals. A main concern for editors, reviewers and readers is to find out whether all individuals enlisted as authors actually fulfill criteria for authorship as defined in the document "Uniform Requirements for Manuscripts Submitted to Biomedical Journals". Revista Médica de Chile is addressing this relevant topic with a combined strategy: (1) A retrospective analysis of the manuscripts published in the recent decades in the Revista will quantify and illustrate the local trend in multiauthorship; (2) A "Statement of accountability": signed by all authors in manuscripts submitted to the Revista, is in use since 1997; and (3) A new form of this "Statement of accountability" requests all authors to identify their personal involvement in the work represented by the manuscript. This information will be available to every person participating in the editorial assessment of the manuscript (editors and external reviewers) but during a trial period of six months authors will be allowed to object the publication of this data, stating the reasons for this objection. After six months the editors will evaluate the information collected and the self-declared role of every author enlisted. The terms "Author" and "Main author" will continue being used to designate participants because "contributor" (replacement alternative proposed by Rennie et al., currently in use by several leading general medical journals) has a different main meaning in Spanish than in English and it might have a negative effect.

Authorship↗

PubMed2000

[Toxic epidermal necrolysis. Therapy in ICU with intravenous immunoglobulins in a case].

We report a 27 years old homosexual male with AIDS that was admitted to the ICU dehydrated, with fever and severe malaise. He had irregular bullae, an extensive purpuric exanthema and a zone of epidermic detachment in the right arm. A toxic epidermal necrolysis was diagnosed and therapy with i.v. immunoglobulins was started. After four days of treatment, bullous lesions disappeared and the extension of exanthema decreased. Toxic epidermal necrolysis is a potentially fatal disease and the use of intravenous immunoglobulins for this condition has been reported as successful.

Acquired Immunodeficiency Syndrome↗

PubMed1999

[Systemic inflammatory response syndrome: is it comparable with severe sepsis?].

BACKGROUND: In 1992, a consensus conference defined the terms systemic inflammatory response syndrome (SIRS), sepsis, severe sepsis and septic shock. Since then, numerous reports have validated the prognostic usefulness of these operative definitions. AIM: To evaluate if sepsis severity criteria, as defined by the Consensus Conference, can be applied to noninfectious SIRS. PATIENTS AND METHODS: Five hundred eighteen patients admitted to 5 intensive care units (ICU) from 4 hospitals were prospectively evaluated during a 3 months period. Patients that met at least one severity criteria were included. SIRS etiology, organ dysfunction and evolution were recorded in each patient. RESULTS: One hundred two patients were included: 79 with sepsis (group I) and 23 with noninfectious SIRS (group II). ICU and hospital mortality were comparable (43 and 48% in sepsis compared to 43 and 51% in non infectious SIRS). The most common sources of sepsis were pneumonia and peritonitis. Group II patients had a wide variety of diseases. ICU stay, APACHE score and number of organs with dysfunction were not different among groups. Only the incidence of renal dysfunction was higher in the septic group. CONCLUSIONS: The Consensus sepsis severity criteria can be applied to noninfectious SIRS, defining a population subset with similar high mortality and organ dysfunction incidence, although with greatly heterogeneous etiologies.

APACHE↗

PubMed1998

[Cost analysis of dialysis treatment at the Odense University Hospital and the Sønderborg Hospital].

The major purpose of this paper is to investigate the treatment costs of dialysis treatment by modality. In this study Odense University Hospital (OUH) and Sønderborg Hospital were chosen as cases. The costs of haemodialysis (HD) treatment are estimated to DKK 341-392,000 per patient during the first year, and DKK 328-379,000 per year the following years. The costs of continuous ambulatory peritoneal dialysis (CAPD) treatment are estimated to DKK 262-291,000 per patient during the first year, and DKK 251-277,000 per year the following years. The costs of CCPD (peritoneal dialysis with the aid of a machine), treatment are estimated to DKK 312-325,000 per patient during the first year, and DKK 296-308,000 per year the following years. The treatment costs of HD are lower than expected, while the treatment costs of PD are higher than expected. As a result of this the differences in treatment costs (HD versus PD) are much lower than expected, DKK 130,000 at the most.

Angioplasty, Balloon, Coronary↗

PubMed1998

Use of methylene blue in patients with refractory septic shock: impact on hemodynamics and gas exchange.

PURPOSE: The purpose of this study was to assess the acute effects of methylene blue, an inhibitor of nitric oxide synthesis, on hemodynamics and gas exchange in patients with refractory septic shock in a prospective clinical trial at medical and surgical intensive care units in a tertiary university hospital. PATIENTS AND METHODS: Prospective, sequential study of 10 consecutive patients admitted with severe septic shock of diverse causes and unable to achieve an adequate arterial pressure despite the use of at least two vasoactive drugs. Six of them also developed acute lung injury. All received 1 mg/kg intravenous bolus of methylene blue. Hemodynamic and respiratory parameters were measured at baseline and at 30, 60, 120, and 180 minutes after the bolus injection. RESULTS: Systolic, diastolic, mean arterial blood pressure, and systemic vascular resistance increased significantly in all patients, whereas no significant changes were observed in cardiac output, oxygen consumption, or oxygen extraction ratio. Gas exchange remained unaffected in patients with acute lung injury. CONCLUSIONS: Methylene blue had an acute vasopressor effect in patients with refractory septic shock, and it was not deleterious on respiratory function.

Adult↗

PubMed1998

[Septic phlebitis: origin of severe septic condition].

We report two patients, an 82 years old female and a 71 years old male, who had a severe sepsis with positive blood cultures for Staphylococcus aureus and a superficial phlebitis as the only probable focus. In both the diagnosis of septic phlebitis was reached and an emergency phlebotomy was performed under local anesthesia. The clinical response was satisfactory and the pathological examination of excised veins showed an acute exudative leukocytic thrombophlebitis.

Aged↗

PubMed1998

[Is the methodology of our original articles essentially inferior to similar papers published in English-speaking journals?].

Randomised controlled trials reported in languages other than English are generally excluded from systematic reviews. This exclusion is often based in the biased opinion that the strictness of methodology and the quality of assessment of the results are essentially inferior to similar articles reported in English. A study published in 1996 in The Lancet compared completeness of reporting, design characteristics, and analytical approaches of 229 randomised controlled trials published in English, French, German, Italian or Spanish, between 1989 and 1994. Eight of those trials had been published in Revista Medica de Chile. No significant differences were found in any single item analysed, between trials published in English and in other languages. The peer review system applied by a journal and the editorial selection of original articles to be published are crucial determinants of the overall quality of its publications. The role of local journals that publish in languages other than English is most important for the communities they are intended to serve and their contribution to disseminating scientific and other important aspects of medicine should be acknowledged and considered by readers, authors and editors in English-speaking countries, especially when these local journals belong to the mainstream literature included in the major international indexing services.

Humans↗

PubMed1997

[Malignant neuroleptic syndrome, medical-psychiatric approach].

We report the case of a 42 years old male, with a bipolar disorder and receiving lithium therapy, valproic acid and clonazepam. Due to an exacerbation of his underlying disease, he was admitted to a psychiatric clinic and received 50 mg of intramuscular chlorpromazine in two occasions. Afterwards, the patient had an alteration of consciousness, fever reaching 39 degrees C and generalized muscular rigidity. Laboratory work-up showed a normal brain CT scan, a diffuse slowness in the EEG and a creatinphosphokinase that reached values of 3.040 U/l. He was transferred to an intensive care unit and treated with sodium dantrolene and bromocriptine, obtaining a good clinical response.

Adult↗

PubMed1997

[Clinical epidemiologic study of patients admitted to the intensive care unit, according to age].

BACKGROUND: Lately, we have observed an increase in the admission to intensive care units of patients over 65 years old, probably due to the increase in life expectancy that is occurring in Chile. AIM: To compare the frequency of admissions to intensive care units in patients over 65 years old, their diagnoses, their severity and hospital course, with those of younger patients. PATIENTS AND METHODS: The charts of all patients admitted to an intensive care unit of a University Hospital, during one year, were reviewed. The diagnosis that caused the admission was considered the main disease. Severity at the moment of admission was assessed using the Apache score. RESULTS: A total of 777 patients were admitted during the study period. Twenty had to be excluded due to lack of reliable data. Four hundred thirty two (57%) were over 65 years old. Cardiovascular diseases were the main cause of admission in young and old patients. Mortality was 14.8% of patients over 65 years old and 18.7% in younger patients. Main causes of death were cardiac arrest, cardiogenic shock, sepsis and cerebrovascular disease. No differences in causes of death were observed between young and old patients. CONCLUSIONS: Patients older than 65 years old admitted to intensive care units are very similar to their younger counterparts in their prognosis and causes of admission.

Adolescent↗

PubMed1997

[A tribute to Germán Schneider, MD, first editor of Revista Médica de Chile].

Germán Schneider was born in 1820 in Magdeburg, Germany, and graduated as M.D. at the University of Bonn. In 1848, caught by the political and intellectual reformist movement in Europe, he was exiled in Paris. As part of a large group of German immigrants, he arrived in Valdivia, Chile, in 1851. Later on he moved to Santiago and in 1871 he was nominated Professor of Clinical Medicine at the University of Chile school of Medicine. An active participant in the academic activities organized by Sociedad Médica de Santiago (a scientific society that evolved into the chilean Society of Internal Medicine) he was the leader of a six-men team who founded Revista Médica de Chile, in 1872. As first Editor of this medical journal, he established the basis for its continuous success and devotion to medical progress and education. Dr. Schneider died in 1884, leaving several distinguished pupils who followed his path, and a medical journal that now stands as one of the oldest in the world.

Chile↗

PubMed1997

[Nitric oxide in respiratory diseases].

Recent reports have described a pathogenic role of nitric oxide in several respiratory disease. It is specially useful in the adult respiratory distress syndrome, where it acts as a selective vasodilator and improves gas exchange, decreasing pulmonary shunting. Although it has a proven bronchodilator effect, its therapeutic role in diseases such as asthma and chronic limitation of airway flow is not well defined. This article review the metabolism, mechanisms of action, potential uses and adverse effects of nitric oxide in respiratory disease.

Asthma↗

PubMed1997

[Study of the survival of elderly patients in intensive care units. Should they be admitted to these units?].

BACKGROUND: An important increase in health care costs has occurred lately, determined in part by the expenses of intensive care units. An important proportion of beds in these units are occupied by elders, with high costs and dubious results. AIM: To study the survival of elderly patients in intensive care units to shed light on the question if these patients should be admitted to these facilities. MATERIAL AND METHODS: We retrospectively analyzed the mortality of 443 patients older than 65 years old, admitted to an intensive care unit between 1993 and 1994. The mortality was compared with that of 334 younger patients admitted in the same period. Severity of disease was determined using admission APACHE II score. RESULTS: Older patients had a higher admission APACHE score than younger subjects (18.4 +/- 8.4 and 14.5 +/- 8.7 respectively, p < 0.01). Mortality during the intensive care unit stay was similar in older and younger patients (18.5 and 14.4%, respectively). Hospital mortality was also similar (22.4 and 25.9%, respectively). Older patients had a higher frequency of chronic diseases and degree of functional impairment. Mortality rates for different diseases were also similar in older and younger patients. CONCLUSIONS: Older age was not associated with a higher mortality during intensive care unit stay. Prognosis is determined by the admission severity score and the number of concomitant chronic diseases.

APACHE↗

PubMed1997

[Improving the editing of medical journals and the World Association of Medical Editors (WAME)].

Medical journal editing is a task with many facets. The role of the editors includes organizing and evaluating a peer-review system as a main tool for their decision making in selecting manuscripts to be published. The International Congress on Biomedical Peer Review and Global Communications was held in September, 1997, in Prague, Czech Republic, organized by JAMA, the BMJ and Project HOPE, and sponsored by several other organizations. A meeting of the World Association of Medical Editors took place during this Congress and its institutional objectives and membership were discussed and enlarged, based on the previous foundation Conference held in Bellagio, Italy, in March 1995. The main goals of this Association: "To facilitate worldwide cooperation and communication among editors of peer-reviewed medical journals; to improve editorial standards, to promote professionalism in medical editing through education, self-criticism and self-regulation; and to encourage research on the principles and practices of medical editing" were accomplished in a warm and friendly atmosphere, with over 300 participants from 46 countries and every continent. Revista Médica de Chile was represented in these meetings by its former and present Editors. An analysis of the meetings by the editorial team will lead to changes intended to improve the editorial process in our journal.

Peer Review↗