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Biomedical subjects

M Barberá Alacreu

Publications and source records attributed to M Barberá Alacreu.

12 recordsLinked to original sources
PubMed2002

[Extrapulmonary tuberculosis in a patient with septic shock].

A 61-year-old woman who was negative for type 1 human immunodeficiency virus developed vertebral osteomyelitis and skin lesions due to sepsis by Staphylococcus aureus. Microscopic examination of the skin showed alcohol-resistant acid-fast bacilli. A polymerase chain reaction (PCR) assay for Mycobacterium tuberculosis was positive for skin and spinal samples, although the cultures were negative. The diagnosis of M. tuberculosis infection is difficult, particularly when the disease is extrapulmonary. Rapid diagnostic tests that use PCR identify the DNA of the bacillus with greater sensitivity than microscopic examination and can give results within 24 hours of receipt of a sample. We analyze the utility of PCR for diagnosing extrapulmonary tuberculosis.

Female↗
PubMedDate not supplied

[Efficacy of 1% ropivacaine with and without hyaluronidase for peribulbar block].

OBJECTIVE: To determine whether adding hyaluronidase to 1% ropivacaine without adrenalin enhances peribulbar anesthesia for cataract surgery with phacoemulsification. PATIENTS AND METHODS: Prospective double-blind study of 100 patients (ASA I-III) scheduled for outpatient cataract surgery with peribulbar blockade. The patients were randomized to two groups of 50 to receive either 10 mL of 1% ropivacaine without adrenalin and without hyaluronidase (Group R) or 1% ropivacaine without adrenalin but with 10 U/mL of hyaluronidase (Group RH). We compared the presence of complete akinesia, of adequacy of surgical conditions, and of the need for reinjection. For statistical analysis we used the chi-squared test and a Student t-test for independent samples, with statistical significance at 5%. RESULTS: A block adequate for surgery was obtained in 98% of the patients in Group RH and in 86.7% of the patients in Group R (p = 0.043). Reinjection was necessary for 28.6% of Group R patients and 8.9% of Group RH patients (p = 0.14). Complete akinesia was similar in the two groups. CONCLUSIONS: The greater efficacy of a peribulbar block with the addition of 10 U/mL of hyaluronidase to 1% ropivacaine without adrenalin, in comparison to 1% ropivacaine alone, was demonstrated by a lower rate of reinjection and ocular mobility, even though no statistically significant difference in either ocular or palpebral akinesia was found.

Aged↗
PubMedDate not supplied

[Monitoring of mechanical ventilation during IPPV: implications due to the intrapulmonary entrapment of gas. Study on a physical model of the lung].

This work was undertaken to determine the possible influence of gas trapping on the values of total respiratory system compliance and on the air flow resistance at the air ways obtained by conventional effects of positive telespiratory alveolar pressure (auto-PEEP) typical of gas trapping on ventilatory dynamics. This study has been carried out in a physical model of the lung. The results support the contention that in the above situation: 1) the total compliance of the respiratory system measured as the quotient between the current volume and the plateau pressure (C.DIN) shows lower values than those of the static compliance (C.EST), and 2) flow resistance at the air ways must be measured as the quotient between the time constant and the plateau pressure. It should not be measured as the quotient between the time constant and the static compliance since in that case the values would be lower than the real ones.

Airway Resistance↗
PubMedDate not supplied

[Propofol in continuous infusion for performing nuclear magnetic resonance in children: an effective alternative to sedation with other drugs].

Sedation is often needed for obtaining nuclear magnetic resonance (NMR) images in children. The aim of this study was to evaluate the efficacy of propofol administered by continuous infusion to non-intubated children for whom our hospital's usual method of sedation (oral chlorohydrate 75 mg/kg at a maximum dose of 2 g plus 4 hours sleep privation the night before) had failed. Deep sedation was induced in 37 ASA I-II children aged 4 and 14 year old, with 2.5 mg/kg propofol followed by 6 mg/kg/h in continuous infusion. An additional dose of 1 mg/kg was administered if the child moved, and the perfusion was reduced to 4 mg/kg if SpO2 fell below 95%. Apnea occurred after induction in 24% (n = 9), 29% (n = 11) required additional doses of propofol, and a tendency to hypercapnia was observed as the imaging procedure progressed. Sedation failed in one child, who required general anesthesia when opisthotonos presented after the induction dose. Awakening was early and satisfactory in all patients, with a score of 2 on the Ramsay scale 15 minutes after NMR. Deep sedation with propofol is a safe and effective method of performing NMR in a child for whom other methods of sedation have failed, provided the child is ASA I-II, monitoring is exhaustive and procedure is carried out by an anesthesiologist.

Adolescent↗