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Biomedical subjects

M Blanco

Publications and source records attributed to M Blanco.

267 records · Page 15Linked to original sources
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[Cocaine and cerebrovascular disease in young adults].

INTRODUCTION AND OBJECTIVE: The use of cocaine has been increasingly associated with cerebrovascular disease specially in young adults. We review the cases of stroke related to cocaine abuse in this group. PATIENTS AND METHODS: We performed a retrospective study between 1989-1998. Data were obtained from the Young Adults Stroke Registry. To investigate the etiology of stroke all patients underwent cardiologic examination, coagulation and neuroimaging tests. RESULTS: We identified 13 patients under 45 years of age with stroke related to cocaine abuse (0.39% of all strokes and 7.60% of the ones in young adults). Mean age in this group was 28.30 years. Eight developed ischemic manifestations (5 infarcts, 2 TIAs and 1 encephalopathy with multiple ischemic lesions), 4 had intraparenchymal hemorrhages and 1 had a subarachnoid hemorrhage. The principal route of administration was intranasal and the time course from cocaine use to stroke ranged from several hours to several years. 61.53% had history of other drug abuse and in 84.61% other risk factors were identified. Angiographic studies demonstrated: arterial occlusions (3 cases), changes consistent with vasospasm (1), segmental narrowing (1) and arterial wall irregularities (1). No aneurysms or arterio-venous malformations were found. The frequency of cocaine-related stroke in young adults has decreased from 8.33% in 1989 to 5% in 1998. CONCLUSIONS: Cocaine is a well known cause of stroke, specially in young adults. In most cases other risk factors can be identified. Multiple overlapping mechanisms may be involved (vasospasm-thrombosis, high blood pressure, embolism.

Administration, Intranasal↗
PubMedDate not supplied

[Blood cultures: use of presumptive antiobiograms].

Mortality associated to bacteremia varies between 20 and 40% depending upon several factors, such as focus of infection, microorganism, host conditions, etc. It has also been documented that mortality may double when the patient does not receive antibiotic treatment to which the microorganism is susceptible. The objective of our work has been to determine the correlation between disk diffusion antibiogram according to NCCLS guidelines, from isolated colonies, and the one performed directly from the blood culture flask. During 1996, in the Institute of Cardiology and Cardiovascular Surgery (ICYCC) in Buenos Aires City, 81 episodes of bacteremia were studied. In every case, an antibiogram was carried out: 1) from the bottle: a- Directly (D), harvesting 20 microliters in Mueller Hinton agar, b- Diluted (d), previous centrifugation and Gram staining to adjust turbidity equivalent to 0.5 Mc Farland; 2) from isolated colonies, according to NCCLS guidelines. There were almost no major errors, except with two strains of Enterobacter cloacae versus cephalotin. The diluted method was not so convenient to read inhibition zones, especially with staphylococci. With gram-positive bacteria, the main problems appeared in the direct method with erythromycin, oxacillin and ciprofloxacin because of minor errors. With gram-negative bacteria, major errors were observed in the direct method, mainly with piperacillin (7%) and to a lesser extent with piperacillin tazobactam (2%). Except for imipenem, trimethoprim sulfamethoxazoie and cefotaxime, all antimicrobial agents presented minor errors with both methodologies. Based upon the high rate of minor errors, we consider it is important to confirm results obtained with the standard technique (NCCLS), considering as presumptive those results from the blood culture bottles (D and d).

Anti-Bacterial Agents↗
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[Escherichia coli virulence factors causing peritonitis, appendicitis and other extraintestinal infections].

Fifty-nine E. coli strains isolated from clinical cases of peritonitis, appendicitis, cholecystitis, wounds and respiratory infections as well as from other miscellaneous sources were investigated. A control group constituted by 475 E. coli strains isolated from the faeces of healthy individuals were also studied. E. coli O-grouped and investigated for production of cytotoxic necrotizing factor CNF1 and alpha-haemolysin (Hly), expression of P fimbriae and mannose-resistant (MRHA) and mannose-sensitive (MSHA) haemagglutination. Virulence factors significantly associated with extraintestinal strains were: production of CNF1 (19% versus 5%, p < 0.001), Hly (27% versus 9%; p < 0.001) and expression of MRHA (44% versus 16%; p < 0.001). The majority of extraintestinal strains (68% versus 36%; p < 0.001), in contrast with faecal E. coli, belonged to O serogroups frequently detected in uropathogenic and bacteraemic E. coli. These results suggest that E. coli causing different types of extraintestinal infections show similar virulence factors and belong to the same serogroups. However, between E. coli isolated from intraabdominal, wound and respiratory infections the number of strains with virulence factors was lower than in E. coli causing urinary tract infections and sepsis.

Animals↗
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[Metalloproteinases and neurovascular injury].

Matrix metalloproteinases (MMP) are a family of proteases involved in the remodelling of the extracellular matrix. In physiological conditions, the activity of MMP is regulated on several levels: gene transcription, activation of inactive precursors, and inhibition by endogenous factors. Loss of control and increased expression and activity of MMP have been implicated in various diseases (cancer, arthritis, vascular aneurysms, atherosclerosis, etc.). In the central nervous system, MMP are involved in the mechanisms associated with neuroinflammation, which is different in vascular and non-vascular diseases. MMP, especially MMP-9, have been shown to induce a high breakdown capacity, especially in the arteriolar basement membrane, leading to cerebral edema and secondary hemorrhage. In human clinical aspects, MMP are associated to intracerebral hemorrhage growth and with the development of complications in ischemic stroke. Combination therapies explicitly involving MMP inhibition could be of value in future treatment strategies.

Cerebrovascular Disorders↗
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[A survey of sleeping difficulties in an urban Latin American population].

AIMS: To report the results of the first regional survey on the prevalence of sleep disturbances in an urban Latin American population. SUBJECTS AND METHODS: Door-to-door and telephone interviews in main urban areas were performed in two phases. In phase one, 1776 adults, aged 18 to 70 were interviewed in Buenos Aires and São Paulo. In phase two, adults aged 18 to 77 were interviewed in Buenos Aires, São Paulo and Mexico City (n = 300 in each city). RESULTS: Two-thirds of those surveyed in phase 1, regardless of age and gender, reported some type of sleep problem within the last 12 months. Up to 25 % of individuals surveyed in phase 2 reported being severely affected or moderately affected by their sleep problems. The severity of the condition increased with age, women being more severely affected than men. On average, individuals reported suffering from sleep difficulties for a period of 5 years and were affected 15.5 nights per month. Although 8.2 hours of sleep was most desired, Latin Americans were sleeping on average 5.8 hours per night. Those severely affected lost about 3 hours per night. Individuals reported stress and worry as the primary trigger for their sleep problems, followed by health concerns. All respondents reported the negative impact of poor sleep on their health and quality of life. CONCLUSIONS: The survey indicates that the prevalence of sleep difficulties in an urban Latin America population is high.

Adolescent↗
PubMedDate not supplied

[Topiramate in comorbid disorders: epilepsy and migraine].

INTRODUCTION: With relative frequency epilepsy and migraine are associated in a same patient. Some times it is difficult to distinguish an attack of others. Reason why it would be of utility to have a treatment effective in both pathologies. It is tried to study in patients with this comorbidity, how of effective it is a drug indicated in the two pathologies, as it is topiramate. PATIENTS AND METHODS: An observational, longitudinal and prospective study is made, where 15 patients are recruited with this association, and which they were treated with topiramate. They are revaluated at three and six months of treatment. RESULTS: Significant differences are obtained (p < 0.05) in all the studied variables (severity and duration of the migraine attacks and frequency of the migraine and epileptic attacks), with a medium dose of 100 mg/day of topiramate, at the end of the study. Not serious adverse effects were observed. CONCLUSIONS: Topiramate in monotherapy seems to be a suitable treatment in patients who undergo epileptic and migrainous attacks jointly.

Adolescent↗
PubMedDate not supplied

Nutritional evaluation and dietetic care in cancer patients treated with radiotherapy: prospective study.

Ninety-three cancer patients about to undergo radiotherapy were studied. These patients were affected by cancer of the head and neck, breast cancer, and abdominopelvic cancer. They were randomly distributed into control and experimental groups. The patients from the control group were allowed to eat ad libitum, whereas those from the experimental group followed a strict nutritional protocol that covered their needs while satisfying their particular tastes and habits. Data were collected the day before radiotherapy commenced and the day treatment ended. Anthropometric, analytical, and clinical parameters were determined. The results showed the benefit of dietetic treatment in experimental patients with head and neck or abdominopelvic cancer.

Abdominal Neoplasms↗
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[Apropos of a case of chronic eosinophilic pneumonia associated with iridocyclitis and bronchial asthma].

In this study, we report the case of a 48 year-old female patient showing a clinical picture after a month's evolution consisting of cough, moderate effort dyspnoea, asthenia, anorexia and loss of weight. One year before, she had been diagnosed with bronchial asthma and she had been treated for two years with policarpine collyrium for a glaucoma simplex. The exploration only showed the existence of iris synechias in the right eye and conjunctival hyperaemia on the same side, together with basal crepitant rales on auscultation. Once we had proved the existence of a peripheral eosinophilia superior to three thousand elements per mm3 and of peripheral pulmonary infiltrates with radiographic negative for pulmonary edema, the picture was included in the so-called P.I.E. syndrome whose various etiologies were discarded subsequently. Following a pharmacological survey, a study of parasites in faeces and cutaneous tests as well as provocative tests, the specific causes of P.I.E. were discarded. According to the transbronchial biopsy and the biopsies of skin, nerve and muscle, it was unlikely that the diagnosis would be granulomatosis and/or angiitis. No evidence was found of any of the affections in which P.I.E. is regarded as a minor component. In view of the above, we thought the correct diagnosis was chronic eosinophilic pneumonia, since all the characteristics defining this picture according to Carrington were fulfilled. The treatment was started with corticoids and a clear improvement of all clinical symptoms was observed, including the ocular findings and the disappearance of radiographic pulmonary infiltrates.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenal Cortex Hormones↗
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[Farmer's lung with antibodies against Thermoactinomyces vulgaris and Aspergillus fumigatus. Clinical course and treatment].

We present a case of Farmer's lung with antibodies to Thermoactinomyces vulgaris and Aspergillus fumigatus. A 56-year-old male patient with an atopic family medical history came to our hospital complaining of cough, dyspnea, fever, asthenia and anorexia. His condition worsened after being exposed to cereal powder, becoming symptomatic after 20 minutes or on occasion after 6 hours. Physical examination showed basal crepitant rales in lung auscultation. The radiograph of the thorax showed a bilateral interstitial reticulo-nodular pattern. An obstructive pattern was found on functional respiratory examination. There was also a slight restriction along with the decrease of the VC and a significant reversal of the M.M.E.F. with anticholinergics. The tests for intradermal cutaneous allergies were positive after 20 minutes and for Aspergillus fumigatus Niger and Terreus (Bencard) after 6 hours. With immunoelectrophoresis and double diffusion, precipitation bands in the presence of Aspergillus fumigatus and Thermoactinomyces, were detected. IgG and IgE were high-1570 mg% and 1000 U/ml respectively. The histological study of the transbronchial biopsy showed dilatation of the alveolar septum caused by a lymphocytic infiltration with fragments of collagenous fibres. In bronchoalveolar lavage there was a predominance of lymphocytes and histiocytes. After exertion, arterial blood gases showed desaturation with hypoxemia. The static lung volumes and the flow and diffusion of carbon monoxide (CO) showed a moderate decrease of vital capacity, with the total lung capacity being below normal. Diffusion was markedly attenuated. The provocation test by indirect bronchial inhalation using cereal powder (Alfalfa) was positive. After six hours dyspnea, cough and leukocytosis appeared with an outbreak of fever and an increase in the erythrocyte sedimentation rate.(ABSTRACT TRUNCATED AT 250 WORDS)

Antibodies, Fungal↗
PubMedDate not supplied

[A critical study of the influence of negative symptoms on the therapeutic response in schizophrenia].

INTRODUCTION: The schizophrenia is considered an heterogeneous disorder which phenomenological differences could to point to etiopathogenic differences. Negative symptoms are associated with poor treatment response. In the last year different operative criteria of the "refractory treatment" concept has been developed. The association between negative schizophrenic symptoms and neuroleptic treatment response is studied. METHOD: An open cross-sectioned design is made. 50 schizophrenics (DSM III-R criteria) inpatients are divided into 2 groups: one of 25 treatment-refractory schizophrenics (defined as Kane criteria, modified), and a second group of 25 treatments-responders schizophrenics. Negative symptoms are evaluated by the SANS into the five days before the hospital discharge. RESULTS: The two groups showed differences in the number of hospital income and total length of stay (p < 0.01). There were no differences in the subscales: "alogia", "affective flattening" and "attention impairments", although differences were found in "anhedonia-asociality" and "avolition-apathy" subscales (p < 0.05). DISCUSSION: Association between negative symptoms-poor outcome is issued. Possible relation between "anhedonia-asociality" and "avolition-apathy" added to social dimension with refractoriness to treatment is suggested.

Adolescent↗