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Biomedical subjects

M Ruano

Publications and source records attributed to M Ruano.

30 records · Page 2Linked to original sources
PubMed1987

The neurologic effects of thiopental therapy after cardiac arrest.

We studied the effect of thiopental loading during resuscitation of 53 patients following cardiopulmonary arrest and compared the outcome with that found in 54 patients treated conventionally in the 30 previous months. Thiopental therapy (10 mg/kg i.v.) was begun within 30 min of the arrest once hemodynamic stability had been established. Thiopental infusion (20 mg/kg over 6 h) was followed by phenobarbital sodium (125 mg every 12 h), tolerance to the initial dose having been assessed. The in-hospital mortality rate for both groups was similar. In patients with ischemic heart disease, the mortality rate within the first 6 h was significantly higher in the thiopental group (p less than 0.05), although for the remaining patients there were more survivors among the thiopental treated patients (p less than 0.05). Excluding the patients who died within the first 6 h, 61% of the patients in the thiopental group survived cardiac arrest with normal cerebral performance, whereas only 37% in the standard treatment group showed normal functional outcome (p less than 0.03). These results suggest a favorable neurologic effect of thiopental loading during resuscitation of patients without ischemic heart disease. In patients with ischemic heart disease, an initial hemodynamic deterioration may contribute to minimising the beneficial effect of barbiturate therapy.

Adult↗
PubMed1984

Myocardial depression in septic shock caused by meningococcal infection.

Comparative hemodynamic measurements recorded in 19 cases of septic shock associated with Neisseria meningitidis bacteremia and in 20 shock cases associated with bacteremia due to other Gram-negative bacilli showed a significantly higher incidence of early myocardial depression in the cases with meningococcal infection. Echocardiographic, ECG, and serum enzyme (CK-MB isoenzyme) studies closely correlated with impaired myocardial contractility and development of cardiogenic shock in patients with meningococcal bacteremia. Autopsy of the heart from three patients who succumbed to shock confirmed the presence of myocarditis with intracellular Gram-negative diplococci. Our observations suggest that the onset of cardiac dysfunction precedes clinical manifestations of shock.

Adolescent↗
PubMed1983

ST changes during sodium nitroprusside therapy in acute myocardial infarction.

Nineteen patients with acute anterior myocardial infarction who were hypertensive (systolic BP greater than or equal to 170 mm Hg and/or diastolic BP greater than or equal to 100 mm Hg) at the time of admission were treated with continuous infusion of sodium nitroprusside (NP). The administration of NP resulted in a significant elevation of ST segments probably related to decreased diastolic BP and increased HR; direct NP effects on coronary circulation cannot be excluded. These changes may indicate a negative effect on the ischemic portion(s) of the myocardium.

Aged↗
PubMedDate not supplied

Increase in thrombin generation after coronary thrombolysis with rt-PA or streptokinase with simultaneous heparin versus heparin alone.

This study compares the extent of inhibition of thrombin generation and activity achieved in patients with acute myocardial infarction receiving fibrinolytic treatment (streptokinase SK, or rt-PA) and concomitant intravenous heparin treatment adjusted to the patients' weight with that achieved with the same heparin regimen but without fibrinolytic therapy. The study involved 90 patients, grouped according to their treatment: SK+heparin; rt-PA+heparin, and heparin without thrombolytic agents. Prothrombin fragment 1+2 (F1+2), thrombin-antithrombin complex (TAT), fibrinopeptide A (FPA) and activated partial thromboplastin time were measured. Patients treated with SK+heparin or rt-PA+heparin and higher F1+2 plasma levels than the patients treated with heparin alone at 12, 48 and 72 h in the case of SK+heparin, and at 12, 24, 48 and 72 h in that of rt-PA+heparin. Compared to baseline, the plasma levels of FPA were decreased in the three treatment groups at 24-48 h. There were no significant changes in TAT and FPA plasma levels among the three treatment groups at the different times. After thrombolytic therapy with both SK and rt-PA, there was an increase in thrombin generation, although high-dose intravenous heparin inhibited the different increases in thrombin associated with the thrombolytic agents to the same extent.

Acute Disease↗
PubMedDate not supplied

A rapid-plate hemagglutination assay for the detection of infectious bronchitis virus.

A rapid-plate hemagglutination (HA) test to detect infectious bronchitis virus (IBV) in allantoic fluid of embryonated eggs was introduced into routine procedures for IBV identification. This system was tested in 468 diagnostic cases received by the Poultry Diagnostic and Research Center at the University of Georgia. Allantoic fluids from inoculated embryos were harvested and treated with commercially available neuraminidase enzyme. IBV in neuraminidase-treated allantoic fluid was identified by clear and consistent HA of chicken red blood cells within 1 min of incubation. The specificity of the neuraminidase rapid-plate HA assay was examined with other avian viruses in individual and dual embryonic infections. Sensitivity of this test was compared with embryo lesions and reverse transcriptase-polymerase chain reaction (RT-PCR). The rapid-plate HA assay of neuraminidase-treated allantoic fluid correlated with the RT-PCR during the early stages of IBV detection, identification, and isolation in embryonated eggs.

Allantois↗
PubMedDate not supplied

Efficacy comparisons of disinfectants used by the commercial poultry industry.

Several commercially available disinfectants used by the poultry industry were evaluated for their effectiveness against selected bacteria and viruses. When tested in the absence of organic matter, most disinfectant products were effective at the manufacturer's recommended level within 10 min of contact time. However, when organic matter was present, longer contact times and/or higher disinfectant dosages were needed to maintain effectiveness. Pseudomona aeruginosa and infectious laryngotracheitis virus were very resistant organisms in the presence of organic matter. Evaluation of disinfectant efficacy against several microbials in the absence or presence of organic matter was highly practical, flexible, and reproducible.

Animal Husbandry↗
PubMedDate not supplied

[Liver transplantation in pediatrics. Nutritional measures].

Malnutrition is a constant in candidates for liver transplant. Because of their particular characteristics, pre-operative nutritional intervention is difficult to apply, so that post-transplant action is necessary. A retrospective study was made, reviewing the clinical records of all the children undergoing liver transplants in 1992 in the "La Paz" Children's Hospital, while they were in the Pediatric Intensive Care Unit. Two groups of patients were established--A and B--respectively of 15 and 7 children, according to whether or not they had received immediate post-transplant TPN. In Group A, a total of 150 days was evaluated, with TPN (x = 10 +/- 8.3). The amino acid solutions used were for liver insufficiency (48.8%), Kidney insufficiency (33.3%) and standard (17.8%). Lipids were administered on 6.3% of days in four patients' nutrition. In 54.5% of interventions, infectious complications occurred due to immune-suppression. Comparison of the two patient groups show significant results: those in Group A had a 3.2 relative risk of suffering infection (certainty interval 1.3-1.8). In terms of time in the ICU, the Group A patients were admitted for an average of 13.4 days (range 2-37) as opposed to the 6.28 days of Group B (range 3-15). Results were significant, with p < 0.05. In terms of evolution, the survival rate in patients receiving TPN was 86.6% against 71.4% in those receiving enteral nutritional (n.s.). Our results show a high rate of survival (86.6%). It is not possible to conclude the extent to which the introduction of TPN influenced post-operative evolution, as there was no consistency in terms of the patients' clinical situation.

Child↗