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Biomedical subjects

M Loscertales Abril

Publications and source records attributed to M Loscertales Abril.

14 recordsLinked to original sources

[High-frequency oscillatory ventilation. A single-center study].

INTRODUCTION: High-frequency oscillatory ventilation is a safe and effective means of delivering mechanical ventilatory support. OBJECTIVE: To evaluate the safety and effectiveness of high-frequency oscillatory ventilation in pediatric patients with acute respiratory failure. PATIENTS AND METHOD: From August 2003 to July 2005, we performed a prospective observational study of 11 children older than 1 month who underwent high-frequency oscillatory ventilation. Pediatric risk of mortality scores (PRISM), Murray lung-injury scores and air leak scores were recorded at baseline before ventilation. The following variables were studied: ventilatory settings (FiO2 and mean airway pressure), gasometric (PaO2, SaO2, PaCO2, pHa, PaO2/FiO2 ratio) and hemodynamic parameters (Partm, PVC), and the oxygenation index. RESULTS: The overall survival rate was 82 %. Significant increases were found in PaO2 (p < 0.05), SaO2 (p < 0.05) and the PaO2/FiO2 ratio (p < 0.05), while mean airway pressure (p < 0.001), oxygenation index (p < 0.001), and FiO2 (p < 0.001) significantly decreased over time. CONCLUSIONS: High-frequency oscillatory ventilation significantly improved oxygenation in children with acute hypoxemic respiratory failure.

Acute Disease↗

[Meningococcal sepsis in our area. Study of the disease severity factors and therapeutic management over a 10-year period].

Meningococcal sepsis with cardiovascular manifestations is one of the leading causes of pediatric intensive care admission (14.85%) in our area. We carried out a two phase study over period of 10 years from 1979 to 1988, involving a retrospective analysis of clinical and analytical manifestations in order to determine a prognostic score of the severity of meningococcal infections in our area. A total of 86 cases were studies over a two year period. After establishing the prognostic score, we applied a previously assayed therapeutic protocol, based on the number of criteria of severity, in 170 children selected as having the same criteria. The factors of seriousness considered were: Appearance of the first symptoms less than 12 h. previously, appearance of petechia less than 6 h. previously, hyperthermia, shock at admission, absence of meningitis, fulminating course of purpura and convulsions, leukopenia less than or equal to 5,000 mm3, prothrombin activity less than or equal to 45%, platelets less than or equal to 75,000 mm3, fibrinogen less than or equal to 250 mgrs% and FPD greater than 40 micrograms/ml (p less than or equal to 0.01 (CHI SQUARE]. In the first phase of study, overall mortality was associated with the presence of three criteria, and was highest when more than seven criteria were present. The results indicate that mortality from meningococcal sepsis is linked to fulminating deterioration of hemodynamics and DIC.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiovascular Diseases↗

[Studying the levels of endotoxemia in meningococcal sepsis. Its relations to pregnancy and antibiotic treatment].

The most frequent cause of toxic shock in our area is meningococcal sepsis. It is currently assumed that endotoxin produce by this bacteria, a lipopolysaccharide with toxic properties, is able to trigger shock and DIC by stimulating both arachidonic acid pathways, among other actions. Previous studies in our laboratory demonstrated significant differences (p +/- 0.001) in the amounts of endotoxins released in vitro by strains from patients and healthy carriers and statistically related criteria of severity with mortality in 256 patients in our center over the last 10 years. In the present study we attempted to establish whether plasma levels of endotoxin were correlated with the severity of the disease. We studied 32 patients with meningococcal sepsis, dividing the subjects into two groups: those in whom six or more criteria of severity were present, and those in whom less than six criteria were found. Blood levels of endotoxin were determined upon admission and after the administration of antibiotics (penicillin and chloramphenicol) using the limulus test with a chromogenic substrate (Coatest, Endotoxin, Kabivitrum, Sweden). Levels of endotoxins were significantly higher in patients with more than six criteria of severity both upon admission (0.6 +/- 0.03) ng/ml) and 4 h. afterward (0.74 +/- 0.006 ng/ml) in comparison to children in whom the clinical picture was less serious (0.27 +/- 0.18 ng/ml and 0.27 +/- 0.18 ng/ml and 0.27 +/- 0.16 ng/ml7 t = 5.8 y t = 5.6 respectively. Endotoxin levels were highest in patients presenting shock, disseminated intravascular coagulation in the hypocoagulability phase and more than 8 criteria.(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Bacterial Agents↗

[Plasma concentration of atrial natriuretic peptide, vasopressin and aldosterone in the umbilical cord blood: its relation to perinatal asphyxia].

Aldosterone, vasopressin (AVP) and atrial natriuretic factor (ANF) plasmatic concentrations were determined in cord arterial blood from 42 newborns to term: 29 healthful and 13 with perinatal asphyxia. Control group showed plasmatic levels (pg/dl) AVP, aldosterone and ANF significantly lower than perinatal asphyxia newborns group (AVP: 2.27 +/- 1.43 vs 4.26 +/- 2.86; aldosterone: 1.113 +/- 384.79 vs 1,540.38 +/- 595.96; ANF: 2.27 +/- 1.43 vs 4.26 +/- 2.86, respectively (p less than 0.05). We found an inverse correlation between umbilical arterial pH vs AVP, aldosterone and AFN, and a direct correlation between ANF vs aldosterone. Perinatal asphyxia induces secretion of the three studied hormonal factors, likely as a physiologic mechanism of fetal adaptation to hydroelectrolytic and hemodynamic changes which occur during the asphyxia.

Aldosterone↗

[PGE and PGF2-alpha levels in the umbilical cord vessels. Relationship to acid-base equilibrium in the umbilical artery].

To asses the possible role of prostaglandins in the fetoplacental circulation during delivery PGE and PGF2-alfa plasma levels were measured in the umbilical vessels of term newborns. The levels of PGF2-alfa in blood from the umbilical vein are significantly higher and more variable than in the umbilical artery; 83.38 +/- 78.05 pg/ml versus 43.28 +/- 5.32 pg/ml. PGE levels are also higher in the vein 114.73 +/- 25.16 pg/ml than in the artery 83.63 +/- 9.22 pg/ml. There was a statistically significant negative correlation between the arterial pH and PGE in the umbilical vein these results support the idea that the plasmatic umbilical prostaglandins are synthetized by the placenta the variability in the values obtained in venous umbilical blood may reflect the different times of ligation of the umbilical cord. A decrease in fetal pH may be the stimulus for the prostaglandin synthesis by the placenta.

Acid-Base Equilibrium↗

[Importance of the function of polymorphonuclear neutrophils in intrinsic and extrinsic asthma. Interaction of whole serum in the control of cellular activity].

A study was made of polynuclear leucocyte function: chemotaxis, NBT reduction and the influence of total plasma on chemotaxis, was investigated in a large group of asthmatic paediatric patients, both during and between asthmatic attacks. It has been proved that polynuclear function is different in the two types of asthma. During the asthmatic's crisis and in the intrinsic patients in intercrisis periods, there is a polynuclear neutrophil hyperreaction when the chemotaxis and the NBT reduction are raised. An inhibited chemotactic activity in the plasma of these patients is noted. This activity doesn't produce irreversible effects on the cells; it acts as a regulating mechanism on the chemotactic factors found in plasmatic fractions.

Asthma↗

[Osmolarity and arginine-vasopressin in children born after acute fetal-neonatal distress].

A study of urinary osmolarities and plasmatic level of arginine-vasopressin (AVP) 48 hours after birth in a group of 70 newborns (30 of which are normal and 40 of which have acute perinatal hypoxia), selected according to previously established criteria is carried out. An evolutionary study of urinary osmolarities of newborns with acute perinatal hypoxia, osmolar index and its relation to plasmatic levels of AVP during the first week of life is also considered. AVP 48 hours after birth was blatantly more elevated among those newborns who had shown acidosis at birth (p less than 0.001) which correlated significantly with urinary osmolarity, although it showed low figures (p less than 0.05). This same correlation (p less than 0.001 and p less than 0.05) appears with osmolar index and urinary osmolarity on successive days, but it is important to point out that vasopressin decreased to base values at the end of the first week of life while osmolarities in urine increased. Conclusions are: 1) AVP is higher after 48 hours of life among those newborns with acute perinatal hypoxia and decreases progressively during the first week of life, being comparable to values obtained from normally born children 48 hours after birth at the eight day of life. 2) Renal response to this hormone is slight during the first days of life.

Arginine Vasopressin↗

[Sweet's syndrome in an infant].

A new case of Sweet syndrome in a six mouth old child is reported. Interesting facts with respect to the age, hematology findings, localization and residual lesions are found. The disease in the pediatric age have been reviewed.

Humans↗