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Biomedical subjects

M Muñoz

Publications and source records attributed to M Muñoz.

At least 271 records · Page 15Linked to original sources
PubMedDate not supplied

[Status of feeding services at Spanish hospitals with dietetic and clinical nutrition unit].

Nutrition at the hospital is substantial to the evolution of the disease. The number of diets in the surveyed hospital ranged between 15 and 70 and was not influenced by the hospital number of beds. The proportion of basal and therapeutic diets is similar (about 50% each), although the number of "special" diets increase with the hospital size. The average periodicity of menus is 14 days, while the optional "menu" is lower in bigger hospitals. The knowledge of the Diet Code in different hospitals is how between physicians and nurses in relation to other health and service professionals. The computerized ordering of diets is higher in those hospitals with more than 1500 beds (66%) and the manual request ranges between 65% and 80% in those with 200 to 1500 beds. Most hospitals have a centralised distribution system with a isothermal tray.

Food Service, Hospital↗
PubMedDate not supplied

[Influencing factors in the control of phosphorus in peritoneal dialysis. Therapeutic options].

UNLABELLED: Impaired phosphate excretion resulting in hyperphosphatemia is one of the earliest consequences of chronic renal failure. To control serum phosphate levels, we can use the following therapies: 1) Restriction of dietary phosphate (but on CAPD, obligatory protein losses via peritoneal fluid makes impractical any reduction of phosphate diet. 2) Reduction of phosphate absorption, using phosphate binders. 3) Peritoneal phosphate removal. OBJECTIVE: 1) To evaluate the factors affecting peritoneal phosphate removal such as plasma phosphate, peritoneal membrane transport type, peritoneal dialysis modality prescription (CAPD or APD) and daily dialysate volume. 2) To test the best calcium concentration in the peritoneal dialysis fluid (5, 6 or 7 mg/dl) in order to permit the use of calcium carbonate or acetate without the risk of hypercalcemia or hyperparathyroidism. METHOD: Phosphate was measured in seventy 24-hour dialysate collections, 33 from patients on CAPD and 37 from patients on APD. 24-hour peritoneal phosphate removal (mg/24 hours) and weekly peritoneal phosphate clearance was calculated (L/week). The peritoneal membrane was studied by the peritoneal equilibrium test (PET), using a 2.27% glucose. We calculated also the peritoneal calcium balance in 25 daily peritoneal fluid collections from patients using a calcium dialysate concentration of 5, 6 or 7 mg/dl each one. IPTH levels and doses of vitamin D were compared at 6 months in patients using a calcium concentration of 5, 6 or 7 mg/dl from the beginning of peritoneal dialysis (5 patients of each calcium dialysate concentration). RESULTS: Weekly peritoneal phosphate clearance (WPC) were higher or APD than on CAPD (51 +/- 21 vs 41 +/- 14, p < 0.005). Daily dialysate volume was also higher on APD (14 +/- 4 vs 7.8 +/- 1.8 L/day, p < 0.001). WPC was higher on APD when a mild-day exchange was done (61 +/- 23 vs 45 +/- 15, p < 0.005), instead an equal total daily volume of the dialysate. Peritoneal calcium balance was significantly more negative in patients using a calcium in the dialysis fluid of 5 than 6 or 7 mg/dl (-125 +/- 7 vs -18 +/- 41 vs -11 +/- 49, p < 0.001). At 6 months, patients using a calcium fluid concentration of 5 mg/dl increased iPTH levels (from 160 +/- 101 to 332 +/- 153, p < 0.001) and vitamin D needs (from 0 to 1.87 +/- 0.37 mcg/week, p < 0.001). In summary, peritoneal phosphate clearance depends on plasma phosphate levels, daily volume of dialysate prescribed and peritoneal membrane transport characteristics. It can be improved by increasing the total peritoneal fluid. On APD, a mild-day exchange may improve phosphate clearance, without total volume increase. The risk of secondary hyperparathyroidism can be decreased with a calcium fluid concentration of 6 mg/dl, which was shown to be better than 5 mg/dl when calcium phosphate binders are not correctly taken.

Calcium↗
PubMedDate not supplied

[Classification of the cerebrovascular diseases. Iberoamerican Cerebrovascular diseases Society].

OBJECTIVES: In view of the several terminologies in countries belonging to the Iberoamerican Cerebrovascular diseases Society it seemed appropriate that the Executive Committee should propose a unified cerebrovascular diseases classification and nomenclature. DEVELOPMENT: Based on the classifications of strokes NINCDS, TOAST, Laussane Stroke Registry, OCSP and that of the cerebrovascular diseases group of the Sociedad Española de Neurología, we devised a system for classification of cerebrovascular diseases with the objective of harmonizing the nomenclature and criteria of Iberomerican countries. We chose the word stroke as the most suitable for the definition of cerebrovascular diseases. These were then divided into symptomatic and non symptomatic. The symptoms were then divided into those of transient ischaemic accidents (TIA) and stroke, and then into ischaemic and haemorrhagic. We established the aetiological subtypes of focal cerebral ischaemia (TIA and ischaemic stroke) as: disease of the great vessels or atherothrombotic, cardio embolic, occlusive small vessel disease, of unusual cause or of unknown origin. Haemorrhagic stroke was divided into subarachnoid haemorrhage and cerebral haemorrhage, which was then subdivided according to the site. CONCLUSION: We consider that this nomenclature is simple and easy to use and in concordance with the international classifications, which permits the use of common terminology that is easily translated into English.

Cerebrovascular Disorders↗
PubMedDate not supplied

Quinapril versus atenolol in the treatment of mild to moderate essential hypertension.

A randomized, double-blind, parallel-group study was conducted to compare the safety and efficacy of the angiotensin-converting enzyme inhibitor quinapril with that of the beta-blocker atenolol. Fifty-six outpatients with mild to moderate hypertension were enrolled in the trial. After a 4-week washout period, 27 patients were treated with quinapril 20 mg once daily and 29 patients were treated with atenolol 50 mg once daily for 4 weeks. During a third 4-week period, the daily doses were adjusted on an individual basis. At the end of the 8-week treatment period, the systolic and diastolic blood pressures were significantly reduced in both groups of patients. Heart rate was significantly reduced only in the atenolol group. Adverse effects were inconsequential and comparable in both groups. Quinapril was shown to be a safe and effective treatment for patients with mild to moderate hypertension.

Adult↗
PubMedDate not supplied

[Obesity and the immune system].

With an increased prevalence of obesity in developed countries, associated chronic diseases rise in a parallel way. Morbidity secondary to overweight and obesity include type 2 diabetes, dislipemia, hypertension, heart disease, cerebrovascular disease, cholelithiasis, osteoarthritis, heart insufficiency, sleep apnoea, menstrual changes, sterility and psychological alterations. There is also a greater susceptibility to suffer some types of cancer, infections, greater risk of bacteremia and a prolonged time of wound healing after surgical operations. All these factors indicate that obesity exerts negative effects upon the immune system. Immune changes found in obesity and their possible interrelations are described in this article. Changes produced during obesity affect both humoral and cellular immunity. It is known that adipose tissue, together with its role as energy reserve in form of triglycerides, has important endocrine functions, producing several hormones and other signal molecules. Immune response can be deeply affected by obesity, playing leptin an important role. Properties of leptin, alterations of leptin levels in different situations and its changes with different medical and surgical therapies for obesity are described in this article.

Antibody Formation↗
PubMedDate not supplied

Iron metabolism, inflammation and anemia in critically ill patients. A cross-sectional study.

INTRODUCTION: For critically patients, enteral immunonutrition results in notable reductions in infections and in length of stay in hospital, but not on mortality, raising the question as to whether this relate to the heterogeneous nature of critically ill patients or to the absence of the altered absorption of specific nutrients within the immunonutrient mix (e.g. iron). Immune-associated functional iron deficiency (FID) is not only one of the many causes or anaemia in the critically ill, but also a cause of inappropriate immune response, leading to a longer duration of episodes of systemic inflammatory response syndrome and poor outcome. OBJECTIVE: This prospective cross-sectional study was undertaken to assess the prevalence of FID in critically ill patients during their stay in intensive care (ICU) in order to find the more appropriate population of patients that can benefit from iron therapy. METHOD: Full blood cell counts, including reticulocytes (RETIC), serum iron (SI), transferring levels (TRF) and saturation (satTRF), serum TFR receptor (sTfR), ferritin (FRT) and C-reactive protein (CRP) were measured in venous blood samples from 131 random patients admitted to the ICU for at least 24 h (Length of ICU stay, LIS; min: 1 day; max: 38 days). RESULTS: Anaemia (Hb < 12 g/dL) was present in 76% of the patients (Hb < 10 g/dL in 33%), hypoferremia (SI < 45 microg/dl) in 69%; satTRF < 20% in 53%; FRT < 100 ng/mL in 23%; sTfR > 2.3 mg/dL in 13%; and CRP > 0.5 mg/dL in 88%. Statistically significant correlations (r of Pearson; *p < 0.05, **p < 0.01) were obtained for serum CRP levels and WBC**, Hb*, TRF**, satTRF*, and FRT**. There was also a strong correlation between TRF and FRT (-0.650**), but not between FRT and satTRF or SI. LIS correlated with Hb*, CRP**, TRF*, satTRF* and FRT**. CONCLUSIONS: A large proportion of critically ill patients admitted to the ICU presented the typical functional iron deficiency (FID) of acute inflammation-related anaemia (AIRA). This FID correlates with the inflammatory status and the length of stay at the ICU. However, 21% of the ICU patients with AIRA had an associated real iron deficiency (satTRF < 20; FRT < 100 and sTfR > 2.3). Since oral supplementation of iron seems to be ineffective, all these patients might benefit of iv iron therapy for correction of real or functional iron deficiency, which in turn might help to ameliorate their inflammatory status.

Anemia↗
PubMedDate not supplied

[Etiology of vulvovaginitis in childhood].

A prospective study on the causal microorganism of vulvovaginitis was done to 100 ambulatory patients seen at a pediatric gynecology unit of a metropolitan hospital at Santiago, Chile, from november 1988 throughout july 1989. Samples of vaginal discharge were taken from each patient and studied for bacteria, fungi and trichomonas. Search of pinworms was also done in 55 patients by the transparent adhesive tape test. It was possible to confirm the etiology of vulvovaginitis in 81 cases. Bacteria were isolated in 68 of them, fungi in 4, Trichomonas vaginalis in one patient and pinworms in 8.

Adolescent↗
PubMedDate not supplied

[Acute phase reaction after inflammatory injury. Experimental study].

It is well known that inflammatory aggression makes important changes in plasma proteins levels. Among all of these proteins, C3 fragment of the complement system and haptoglobin, Acute Phase Reactants Proteins, are considered important mediators of the inflammatory response although their specific behaviour is not completely understood. In this work we have studied the modification of both proteins after an inflammatory aggression, which was experimentally induced in rats, trying to connect their behaviour with the lesion stages. Our data show that the plasmatic level of both proteins is increased during the inflammatory aggression, although haptoglobin level gives a more accurate approach to the local phenomenons which occur in the inflammatory focus. This fact suggests that each acute phase reactant has a certain specificity depending on the kind of aggression suffered by a patient.

Acute-Phase Proteins↗
PubMedDate not supplied

[Acute-phase reaction after inflammatory aggression. Experimental study].

It is well known that inflammatory aggression makes important changes in plasma proteins levels. Among all of these proteins, C3 fragment of the complement system and haptoglobin, Acute Phase Reactants Proteins, are considered important mediators of the inflammatory response although their specific behaviour is not completely understood. In this work we have studied the modification of both proteins after an inflammatory aggression, which was experimentally induced in rats, trying to connect their behaviour with the lesion stages. Our data show that the plasmatic level of both proteins is increased during the inflammatory aggression, although haptoglobin level gives a more accurate approach to the local phenomenons which occur in the inflammatory focus. This fact suggests that each acute phase reactant has a certain specificity depending on the kind of aggression suffered by a patient.

Acute-Phase Reaction↗
PubMedDate not supplied

A study of the renin-angiotensin-aldosterone system in severe infantile malnutrition.

Renin activity, renin substrate and aldosterone were measured in plasma of 17 children aged 12 to 28 months and suffering from severe malnutrition (marasmic kwashiorkor). Plasma renin activity was very high (median 29.0 ng/ml/hr) at admission, decreased after equilibration with a normal sodium diet (9.9 ng/ml/hr) and was negatively correlated with urinary sodium excretion. Plasma renin substrate and aldosterone concentrations were in the normal range; plasma aldosterone correlated positively with serum potassium. The hyperactivity of the renin-angiotensin system may be of relevance to the renal function in severe malnutrition.

Aldosterone↗