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Biomedical subjects

P Cardona

Publications and source records attributed to P Cardona.

At least 19 recordsLinked to original sources

Stability of Adderall in extemporaneously compounded oral liquids.

The short-term stability of Adderall in three extemporaneously compounded oral liquids was studied. Three suspensions of Adderall 1 mg/mL were prepared from commercially available 10-mg Adderall tablets with Ora-Sweet, Ora-Plus, and a 1:1 mixture of Ora-Sweet and Ora-Plus. Each suspension was stored in the dark in a stability chamber at 25 degrees C and 60% relative humidity for 30 days. The stability of the active drug (a mixture of levoamphetamine and dextroamphetamine salts) in each of the three vehicles was determined immediately after preparation and at 10, 20, and 30 days by using gas chromatography-mass spectrometry (GCMS). No significant changes in concentrations of either amphetamine isomer occurred during the 30-day study period. Visual inspection of samples revealed no changes in color or odor. Extemporaneously compounded liquid oral formulations of Adderall 1 mg/mL in Ora-Sweet, Ora-Plus, or a 1:1 mixture of Ora-Sweet and Ora-Plus were stable for at least 30 days at 25 degrees C and 60% relative humidity.

Administration, Oral↗

Nursing staff time allocation in long-term care: a work sampling study.

The effective use of nursing staff time is a major determinant of the quality of care in long-term care facilities. The purpose of this work sampling study was to identify those activities that consumed the largest amount of staff time on a locked unit housing: 60 chronically ill and demented patients. A heavy work load, large proportion of direct care, and minimal nonproductive time were found. Work redesign strategies to improve staff efficiency and implications for further research are discussed.

Aggression↗

[Diagnostic imaging of osteoid osteoma].

Conventional radiography, bone scintigraphy and Computed Tomography (CT) are the most useful tools to identify osteoid osteomas. We examined 26 patients (14 men and 12 women) with osteoid osteoma in different skeletal sites (13 femora, 3 tibiae, 3 hands, 2 peroneal bones, 2 humera, 2 spines and 1 talus) and compared the diagnostic yield of the above techniques. The fundamental radiographic findings in this benign bone lesion are the presence of a "nidus", with or without calcifications, perilesional sclerosis and periosteal new bone formation. Four patients in our series had soft tissue edema. In the majority of cases, conventional radiography is the imaging method of choice, because it is easily available and its diagnostic yield is adequate (17 patients in our series), especially if combined with bone scintigraphy-whose high diagnostic sensitivity was proved in all of our patients. CT is recommended for its better spatial resolution, in view of surgery, especially when soft tissues are involved. MRI is a highly valuable tool in bone tumor staging because it demonstrates cortical involvement and intramedullary and soft tissue spread. However, MR findings might be misinterpreted as indicating a more aggressive pathologic process.

Adolescent↗

[Course of radiologic changes in spondyloarthropathy caused by dialysis].

Destructive spondyloarthropathy (DSA) has been observed in patients undergoing long-term hemodialysis. The pathophysiology of this condition is still unknown, but there is evidence that amyloid depositions play an important role in its development. Despite several reports, the radiological evolution of these lesions is poorly known. The authors report the results of the radiographic follow-up (12-18 months) of 9 cases (7 female and 2 male patients; age 63 +/- 6 years) hemodialyzed for over 60 months (mean: 126 +/- 33). In 7 cases, radiographic patterns of destructive arthropathy were seen in peripheral joints as well. X-ray pictures demonstrated: 1) increased erosion of vertebral end plates (in all cases); 2) increased narrowing of intervertebral spaces (in 5 cases); 3) increased collapse of vertebral bodies (in 5 cases); 4) increased malalignment of the involved segments (in 4 cases). In 3 autopsied cases beta 2-microglobulin amyloid depositions were found in disc and ligamentous paravertebral tissue. These results confirm that: 1) DSA is progressive in long-term hemodialysis patients; 2) radiographic evolution is often very quick; 3) the cervical spine is the most frequently involved location and the one where lesions are quickest to develop; 4) severe malalignment of the involved spine may be present, with subsequent neurological complications.

Aged↗

[Double-contrast arthrography of the knee: a digital technique study].

From October 1989, in our Radiology Department, digital radiographic techniques have been applied to double-contrast arthrography of the knee. In this preliminary work we examine the diagnostic contribution of computed radiography to arthrographic findings by comparing image quality of conventional and digital radiographs using a dedicated Philips unit. The digital unit is compatible with all the extant radiographic equipment in our department and automatically supplies two images, the first one resembling a conventional radiograph, the second one characterized by a broader exposure range that allows a clear visualization of soft tissues. To obtain high-quality radiographs the processing curves of the system were modified, in particular by shifting the curve leftward, thus reducing its slope, and by amending the parameters related to spatial frequencies. The changes in the reading curves made these images more useful: they were more homogeneous and allowed a better evaluation of fine details. Relative to the second type of images, characterized by both edge enhancement and a broader recording range, it was enough to shift the curve along the X-axis to compensate for a moderate image overexposure. Keeping in mind that the aim of this preliminary work was not compare the two techniques from a diagnostic point of view, in the authors' opinion the two yield similar information for the diagnostic evaluation of meniscal traumas. On the contrary, if the same principles are applied to the evaluation of capsulo-ligamentous components, digital arthrography appears to be more accurate than the conventional technique, the latter being deceptive especially in the evaluation of cruciate ligaments.

Arthrography↗

[Radiology of osteoarticular changes in patients undergoing periodic hemodialysis for more than 15 years].

Osteoarticular complications, which are characterized by osseous pain, pathologic fractures, and decreased articular mobility, represent one of the major problems affecting long-term (over 15 years) hemodialysis patients. These changes seem to have a multifactorial etiology; they include osteomalacia, secondary hyperparathyroidism, and dialysis-related amyloidosis. Ten patients (5 males and 5 females, mean age 55 +/- 7 years) on long-term (over 15 years) hemodialysis were submitted to X-ray examinations of the skull, spine, shoulders, wrists, pelvis, and knees. Serum calcium, phosphorous, parathyroid hormone, alkaline phosphatase, and basal aluminium levels were also calculated. Osteopenia was demonstrated in all patients. Seven of them had alterations due to hyperparathyroidism. Six patients exhibited signs related to dialysis spondyloarthropathy; in 9 cases amyloid lesions, geodes, and erosions were present in wrists, humeral heads, or hips. One patient exhibited osteomalacic changes. Most long-term dialysis patients presented multifactorial osteoarticular changes due to hyperparathyroidism, osteomalacia, and dialysis-related amyloidosis. Clinical symptoms and decreased articular mobility appeared to be due mainly to amyloid osteoarthropathy.

Adult↗

Destructive spondyloarthropathy and radiographic follow-up in hemodialysis patients.

Nine patients undergoing regular dialytic treatment for more than 60 months showed clinical and radiologic features of a noninfective and destructive spondyloarthropathy. The cervical spine was most affected (100%), followed by the dorsal (three patients, 33.3%) and the lumbar spine (two patients, 22.2%). Typically, radiographs and CT scans revealed narrowing of intervertebral spaces, with destruction or sclerosis of the subchondral bone of the vertebral plate. Autopsy was performed on three patients; histologic study demonstrated the presence of large amyloid deposits containing beta 2-microglobulin (beta 2-m) in the discs and peridiscal ligaments. A radiographic follow-up of the cervical spine was performed in seven patients after a period of 12 months and showed that the bone destruction in DSA is very rapid and progressive. The lower biocompatibility of the cuprophan membranes of dialyzers is probably the factor most responsible for hyperproduction of beta 2-m and subsequently osteoarticular deposition of a new type of amyloidosis.

Aged↗

[Echo-guided biopsy in peripheral pulmonary lesions. Our experience].

Twenty-nine patients with peripheral intrathoracic lesions underwent real-time US and US-guided biopsy. The lesions were mainly atypical fluid collections in 3 patients and mainly solid in the extant 26. Biopsies performed with fine aspirating or cutting needles (20-22 gauge) were successful in all patients; an unquestionable diagnosis was made in 27 cases with cytology and/or histology. Only one patient experienced mild asymptomatic pneumothorax after biopsy, which did not require chest-tube drainage. The authors stress the important diagnostic role of US-guided fine-needle biopsy as an useful and safe method for the evaluation of peripheral intrathoracic lesions.

Adult↗