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Biomedical subjects

M Uribe

Publications and source records attributed to M Uribe.

At least 55 records · Page 3Linked to original sources
PubMed1992

[Assessment of knowledge of cardiopulmonary resuscitation].

The knowledge about standardized CPR of 41 physicians and 30 7th grade medical students was evaluated using a written multiple choice test. Results showed a severe lack of information about CPR in both groups; the test was approved by 39% of physicians and 10% of medical students. Among physicians, the lower achievements were obtained by traumatologists and the best by internists. The basic level of questions were approved by 63% of physicians and 43% of medical students. The principal deficiencies were on pharmacological management and CPR in trauma. It is concluded that education programs on CPR, similar to those given by the American Heart Association, are urgently needed among physicians and medical students.

Cardiopulmonary Resuscitation↗
PubMed1991

The role of calcium ions and calcium channel entry blockers in experimental ischemia-reperfusion-induced liver injury.

Verapamil administered before treatment, but not after treatment, had a beneficial effect on a 90-minute warm ischemia-reperfusion rat liver injury model. The possible activation of proteases converting the xanthine dehydrogenase to xanthine oxidase, the significant mitochondrial calcium loading during the ischemic period, and the potentiation of calcium and oxygen-derived free radicals to promote injury to mitochondria are mechanisms supported by this study, based on both histologic observations and on the pattern of enzyme leak after the acute ischemic event.

Alanine Transaminase↗
PubMed1990

Histamine blockade and cardiovascular changes following heparin administration during cardiac surgery.

Large doses of heparin given as a bolus may produce hypotension; however, conflicting reports exist about the mechanisms involved. This study was undertaken to determine the role of histamine in beef lung heparin-induced hypotension and the efficacy of histamine-receptor blockade in attenuating this undesirable side effect in patients undergoing cardiac surgery. Two hundred patients with good ventricular function were studied after they were randomized into four equal groups. Group I (control) received no histamine-receptor blockade, group II received 1 mg/kg of diphenhydramine 30 minutes prior to heparin administration, group III received 5 mg/kg of cimetidine 4 hours and again 30 minutes before heparin administration, and group IV received 1 mg/kg of diphenhydramine 30 minutes prior to heparin administration and 5 mg/kg of cimetidine 4 hours and 30 minutes before heparin administration. Hemodynamic variables, plasma histamine, and ionized calcium levels were measured before and after heparin administration. Significant hypotension occurred in group I patients after heparin administration. Mean arterial pressure decreased from 95 +/- 5 to 67 +/- 1.5 mm Hg (P less than 0.005) after 1 minute and to 85 +/- 2 mm Hg (P less than 0.05) at 4 minutes. Those changes were significantly greater than in group II (P less than 0.025) and Group IV (P less than 0.005) patients, in whom no significant hypotension was found. In group III, mean arterial pressure decreased from 92 +/- 3 to 75 +/- 1 mm Hg (P less than 0.05) after 1 minute and returned toward baseline values after 4 minutes. Histamine levels increased significantly in all groups of patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Pressure↗
PubMed1990

Tuberculosis of the pancreas.

A 67-year-old woman was admitted to the hospital because of intermittent pain in the upper left quadrant of the abdomen. Ultrasound and computed tomography (CT) scan revealed a mass in the body of the pancreas, and angiography demonstrated encasement of the celiac trunk and splenic vein thrombosis. She was thought to have a pancreatic carcinoma and was surgically explored to obtain tissue for diagnosis. A hard and irregular tumor was found, and biopsies revealed granulomatous inflammation with caseous necrosis. The final diagnosis was tuberculosis, and treatment with rifampicin, isoniazid, and ethambutol was undertaken. One year later the patient is asymptomatic and new CT scan shows disappearance of the pancreatic mass.

Aged↗
PubMed1990

Allergic and nonallergic rhinitis: their characterization in a tropical environment.

The differences between allergic and non-allergic rhinitis were evaluated in 127 individuals from tropical urban region of Venezuela. The study design had historic data obtained regarding exacerbation of initial symptoms on exposure to common precipitants, physical examination, nasal cytology, immunodiagnostic test, routine laboratory test (fresh stool test, white cell count and urine test) and sinus x-rays. Forty nine patients were diagnosed as having allergic rhinitis (AR), 10 as probably having AR, 13 had infectious rhinitis, 4 had mixed components, 1 as non-allergic non-eosinophilic rhinitis, and 50 had no evidence of immunological nasal respiratory allergy and were taken as controls. The associated findings with allergic rhinitis were: conjunctivitis 62%, sinusitis 23%, and bronchial asthma 24%. Our results support a significative prevalence of allergic rhinitis in this particular group, with similar symptom patterns to that of industrialized countries.

Adolescent↗
PubMed1990

Oxygen-derived free radicals in hepatic ischemia and reperfusion injury in the rat.

We have previously described a chronic, in vivo biochemical and histologic model of ischemia and reperfusion injury and wished to test the ability of superoxide dismutase, catalase and allopurinol to protect against the hepatocellular injury demonstrated by this model. Xanthine oxidase inhibitors given preoperatively produced a significant hepatocellular protective effect when compared with a comparable insult delivered to a cohort of control rats. The protection given seemed greater than that produced by pretreatment with free radical scavengers. Possible mechanisms for this observation are discussed. Investigations combining free radical scavengers with xanthine oxidase inhibitors may further define protection for warm hepatic ischemia and reperfusion injury.

Allopurinol↗
PubMed1988

Ten years of selective shunts for hemorrhagic portal hypertension.

Selective portosystemic shunts have been performed in our hospital since 1973 for the treatment of variceal bleeding secondary to portal hypertension. We report our experience in 139 selective operations performed in a 10-year period (1973 to 1983). One hundred thirty patients underwent elective nine underwent emergency surgery. Eighty-five patients were classified in the A functional group of Child, 42 in group B, and 12 in group C. The overall mortality rate in the emergency group was 44% and in the elective group, 13%. Ascitis and transitory hepatic failure were the most common postoperative complications. The long-term follow-up clinical encephalopathy rate was 16%. The survival rate according to the Kaplan-Meier survival analysis was 80% at 2 years, 68% at 5 years, and 67% at 10 years.

Adolescent↗
PubMed1987

Lactitol, a second-generation disaccharide for treatment of chronic portal-systemic encephalopathy. A double-blind, crossover, randomized clinical trial.

A double-blind crossover trial was performed to test the therapeutic usefulness and safety of lactitol, a beta-galactoside sorbitol, against lactose in 18 patients with chronic portal-systemic encephalopathy (PSE). The study included four periods: two for washout and two for lactitol and lactose administration. During washout periods, which lasted two weeks each, patients were stabilized with neomycin plus milk of magnesia. Lactitol and lactose were administered during four weeks each. Ten patients were randomly assigned to receive lactose (group A) and eight patients to receive lactitol (group B) first. PSE parameters, ie, mental state, number connection test performance, asterixis and blood ammonia levels were assessed fortnightly. Electroencephalographic tracings and stool pHs were evaluated at the end of each study period. After the first administration of lactose and lactitol, no statistically significant differences in PSE parameters were found. At the same stage, a significant stool acidification (P less than 0.05) was detected. It is concluded that lactitol seems to be safe and efficacious in treating patients with chronic PSE.

Clinical Trials as Topic↗
PubMed1986

Sugiura procedure outside Japan. The Mexican experience.

In the last 10 years, we operated on 231 patients with hemorrhagic portal hypertension. Most of these patients had some form of liver disease. We performed various surgical procedures: 47 conventional shunts with H grafts and terminolateral portacaval shunts with arterialization of the portal stump, 139 selective Warren shunts, and in those patients in whom a selective portasystemic shunt could not be performed for technical reasons, esophagogastric devascularization in the form of the Sugiura procedure. Forty-five patients were treated with the Sugiura procedure as a one stage or two stage procedure. A total of 68 emergency and elective operations were performed. The operative mortality rate for the emergency thoracic operation was 41 percent and for the abdominal operation, 42 percent. The overall operative mortality rate in the emergency group was 41 percent. The incidence of recurrent variceal bleeding and encephalopathy was 0 in the surviving patients. The survival rate at 3 year follow-up was 40 percent. The elective group was made up of 24 patients. Eighteen patients had a two stage procedure and 6 patients had a one stage procedure. The operative mortality rate for the abdominal operation was 11 percent, whereas that for the thoracic operation was 7 percent. The operative mortality rate for the one stage procedure was 16 percent. The overall operative mortality rate in the elective group was 10.8 percent. None of these patients had recurrent variceal bleeding and encephalopathy developed in only one (5 percent). The encephalopathy was easily controlled with medical treatment. The 3 year survival rate was 83 percent. We conclude that the Sugiura procedure is an effective procedure to treat hemorrhagic portal hypertension when a selective shunt cannot be performed.

Adolescent↗
PubMed1985

Successful administration of metoclopramide for the treatment of nausea in patients with advanced liver disease. A double-blind controlled trial.

A double-blind comparison of metoclopramide versus placebo was performed on 8 cirrhotic patients with nausea (8 cases) and heartburn (3 of the 8 cases) plus mild portal-systemic encephalopathy. As metoclopramide is a dopamine antagonist and dopamine-inadequate neurotransmission has been implicated in the pathogenesis of hepatic coma, this study was also designed to evaluate the effects of metoclopramide on mental state. The study included basal, placebo, metoclopramide, and final periods; each period lasted for 2 wk. Throughout the study patients received 3 g/day of neomycin and an 1800-cal diet containing 40 g/day of mixed protein. During the placebo and metoclopramide phases patients received either two 10-mg metoclopramide capsules t.i.d. or identical placebo capsules. During the study, biweekly liver function tests and portal-systemic encephalopathy parameters were evaluated. A self-evaluation for the presence of nausea and heartburn was also obtained. To monitor the dopamine-blockade effect of metoclopramide, serum prolactin levels were measured. Metoclopramide significantly suppressed the subjective signs of nausea (7 of 8 cases) and heartburn (all cases). Serum prolactin levels were 22 +/- 21 ng/ml, 30 +/- 31 ng/ml, 110 +/- 57 ng/ml (p less than 0.01), and 18.6 +/- 2 ng/ml during basal, placebo, metoclopramide, and final periods, respectively. In spite of these signs of dopamine blockade, no deterioration in mental state, asterixis, electroencephalograms, blood ammonia levels, or psychometric testings were observed. In addition, no extrapyramidal signs were noticeable during any period of the study. One patient presented transient somnolence at the end of the metoclopramide period. We conclude that dopamine blockade is not associated with the appearance of portal-systemic encephalopathy. Metoclopramide is a safe and effective treatment for nausea and heartburn in patients with advanced liver disease.

Chronic Disease↗
PubMed1985

Beneficial effect of vegetable protein diet supplemented with psyllium plantago in patients with hepatic encephalopathy and diabetes mellitus.

A controlled crossover study was performed in 8 diabetic patients with chronic portal-systemic encephalopathy. After a basal period the patients were treated during periods A and B. During period A, a meat protein diet (0.8 g/kg body wt, approximately 1800 kcal/day) was consumed and neomycin plus laxatives were given. During period B patients received vegetable protein (0.8 g/kg body wt, 1800 kcal/day). This diet was supplemented with psyllium fiber to reach 35 g of fiber per day. Four patients were randomly assigned to receive the treatments in the order A-B and the other 4 patients in the order B-A. At the end of the first experimental period, fasting glucose levels were 204 +/- 86 mg% in the meat protein diet group and 127 +/- 8 mg% in the vegetable protein diet group (p less than 0.014). The patients were receiving 2.5 +/- 0.2 g/day and 2.1 +/- 0.5 g/day of tolbutamide at the end of the meat protein diet and vegetable protein diet, respectively. In all cases, fasting glucose levels decreased at the end of the vegetable diet period regardless of the previous treatment. An improvement of greater than or equal to 25 mg% of fasting glucose levels was observed in 7 of the 8 patients after the vegetable protein diet and in no case after the meat protein diet (p less than 0.0078). The parameters of encephalopathy were comparable at the end of both the meat protein diet and the vegetable protein diet. A significant increase in the number of bowel movements was noticed after the vegetable diet plus fiber (p less than 0.01). We propose the use of vegetable diet plus fiber to facilitate the treatment of patients with both diabetes and hepatic encephalopathy.

Adult↗
PubMed1985

Medullary carcinoma of the thyroid gland. Clinical, pathological, and immunohistochemical features with review of the literature.

Twenty medullary carcinomas of the thyroid gland were examined for the presence of immunoreactive calcitonin, thyroglobulin, glucagon, keratin, gastrin/CCK, carcinoembryonic antibody (CEA), insulin, serotonin, adreno-corticotropic hormone (ACTH), prostatic acid phosphatase, and somatostatin using the immunoperoxidase peroxidase-antiperoxidase technique. In addition, they were stained with mucicarmine, alcian blue/periodic acid-Schiff (PAS), Grimelius, Congo red, crystal violet, and Fontana-Masson stains. Calcitonin-immunoreactive cells were absent in one tumor and present in 19 tumors (95%). Thyroglobulin was present in seven tumors (35%). Twenty tumors contained CEA-immunoreactive cells (100%). Fourteen cases were immunoreactive to serotonin (70%) and 12 were positive for somatostatin (60%). Glucagon- and gastrin/CCK-immunoreactive cells were found in two cases each (10%). Four tumors (20%) contained ACTH-immunoreactive cells and three cases (15%) were positive for prostatic acid phosphatase. Five cases (25%) contained keratin-immunoreactive cells. One case was immunoreactive to insulin (5%). Grimelius-positive cells were present in 19 of the cases (95%). Mucin-containing cells were present in 65% of the cases. The validity of the immunocytochemical localizations was tested by specific absorption of each antibody with the corresponding antigen. The demonstration of immunoreactivity for multiple antigens in each of the 20 cases suggests that the origin of medullary thyroid carcinomas is from a neuroendocrine cell potentially capable of producing numerous hormone substances. In addition, as the neoplastic cells in 35% of the tumors contained hormonal substances as well as thyroglobulin, it is suggested that papillary or follicular tumors mixed with a neuroendocrine component exist more commonly than previously suspected. Finally, psammoma bodies might be present in pure medullary carcinoma of the thyroid gland.

Acid Phosphatase↗