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Biomedical subjects

P Núñez

Publications and source records attributed to P Núñez.

At least 19 recordsLinked to original sources
PubMed2003

Ciprofloxacin implants for bone infection. In vitro-in vivo characterization.

To elucidate the antibiotic release mechanism from implants composed of calcium phosphates (hydroxyapatite [HAP] and tricalcium phosphate [TCP]), 30 kDa poly(DL-lactide) (PLA-30) and ciprofloxacin (CFX), nine formulations were prepared. In vitro results show that the release rate decreased as compression load and PLA/phosphates ratio increased. In contrast, a slower percent release rate was observed with higher drug loading. Swelling-erosion-disintegration of the implants was observed during the release assays, due to CFX swelling. Two CFX implant formulations were selected for implantation in the femur of rabbits, according to in vitro results. The implant drug loads tested were 10% and 40% of CFX. The in vivo results showed that the antibiotic concentrations achieved throughout the femur were higher for 4 weeks than the minimum inhibitory concentrations (MIC) against the most common of the pathogens that cause osteomyelitis. The CFX-10% implant was considered the best formulation as CFX was totally released within 6 weeks, and therapeutic bone levels were achieved, and the histological and radiographic analyses showed the osteoconductive properties of the materials. All these results showed that CFX release is limited by its solubility, and the erosion-disintegration and bone ingrowth into the implants enhanced the antibiotic release.

Animals↗
PubMed1998

[Correlation between myocardial perfusion and coronary angiography].

Determining the severity of coronary heart disease is of great importance to the cardiologist. There is a very good correlation between the severity of coronary heart disease and perfusion abnormalities to the myocardium as determined by radioisotope studies. We present our experience with forty (40) cases of ischemic heart disease diagnosed with sestamibi and its correlation with the obstruction of the coronary arteries by angiography. There is good correlation between the sestamibi findings and the coronary artery angiography obstructions and our findings concur with those published in the literature, which is between 75-85%.

Adult↗
PubMed1997

[Rescue angioplasty].

This article resumes the modern management of acute myocardial infarction. It analyzes the complementary benefits of two different types of treatment: thrombolytic therapy and percutaneous transluminal angioplasty.

Angioplasty, Balloon, Coronary↗
PubMed1995

[Complex and multiple vessel angioplasty].

The authors present the clinical history of a 66 year old woman with a previous anterior myocardial infarction and periinfarct ischemia as well as ischemia in another area not related to the scar (in the posterolateral region of the left ventricle) in whom they successfully performed percutaneous coronary angioplasty of the anterior descending and circumflex arteries since the patient was not a candidate for surgical revascularization because of her clinical condition.

Aged↗
PubMed1994

[Heart failure. New concepts, new medications].

It is possible, in our midst, to obtain a survival rate of 68% and a marked improvement in the functional capacity of patients with advanced cardiac insufficiency due to systolic myocardial dysfunction through the combined use of ACE inhibitors, diuretics and digitalis as the main therapeutic agents. Patients with cardiac failure due to atherosclerotic heart disease have a slight better prognosis than those whose failure is secondary to dilated idiopathic congestive cardiomyopathy. The incidence of arrhythmias, sudden death and peripheral embolism suggest that the use of Amiodarone as antiarrhythmic agent and of Warfarin as anticoagulant should be increased. Each of these agents was used in only 26% of our patients.

Aged↗
PubMed1991

[Coronary transluminal angioplasty. A reality in Panama].

This communication describes the first successful Transluminal Coronary Angioplasty performed in the Republic of Panama. The patient was a 77 year old man who developed post-infarction angina twenty days after an acute inferior myocardial infarction. He had new manifestations of ischemia of the posterior-lateral left ventricular wall. Dilatation of a severe proximal lesion of a large right coronary artery, the culprit vessel, was accomplished without complications.

Aged↗
PubMed1990

Complete atrioventricular canal and tetralogy of Fallot: surgical management.

Between 1982 and 1989, nine patients with complete atrioventricular (AV) canal and tetralogy of Fallot underwent successful repair of both anomalies. Seven patients had Down's syndrome. One or more previous palliative shunts had been used in six patients. Associated cardiovascular lesions included persistent left superior vena cava (two patients), patent ductus arteriosus with marked stenosis of the left pulmonary artery (one patient). The diagnosis was confirmed by cardiac catheterization and cineangiography. Closure of the ventricular septal defect was performed through a combined right atrial and ventricular approach in each patient. The right ventricular outflow obstruction was relieved with the use of a transannular patch (4), right ventricular infundibular patch (4) or a valved external conduit (1). There were no hospital deaths. One patient died as a result of meningitis 2 years after repair. Progressive left AV valve incompetence developed in one patient requiring valve replacement. A single atrial approach may not provide the best exposure of the subaortic end of the defect. In this regard, we recommend an additional right ventriculotomy in order to ensure safe closure of the septal defect. Although an adequately shaped isolated patch could be sufficient to close the anterior VSD, we favour a separate patch to minimize the possibility of producing subaortic obstruction. A further method to avoid this subaortic stenosis consists of dividing the common anterior leaflet to the right towards the lateral extent of the infundibular septum.

Blood Vessel Prosthesis↗
PubMed1990

[Lovastatin. A new drug for the treatment of hypercholesterolemia].

Thirteen patients with Hypercholesterolemia were selected for therapy with the new lipid-reducing agent LOVASTATIN The most important criterion for entrance was total cholesterol values over 250 mg/dl in spite of an appropriate diet. The initial dose was 20 mg daily. The patients were re-examined at four weeks intervals and the dose was increased in those with total cholesterol values over 200 mg/dl. In each re-examination they had a complete physical and determination of multiple laboratory parameters. Therapy with LOVASTATIN was effective. The total cholesterol levels decreased by 31% and LDL--cholesterol decreased by 40%. There were no significant changes in the levels of triglycerides or HDL-cholesterol. No important toxicity or side effects were associated with the use of this medication.

Adult↗
PubMed1989

[Intravenous thrombolytic therapy in acute infarct of the myocardium].

Treatment of acute myocardial infarction with plasminogen activators represents a significant advance in cardiovascular pharmacotherapy. This paper describes the first local treatment experience of myocardial infarction in two patients with intravenous thrombolytic agents. The indications and general aspects of thrombolytic treatment are discussed. Thrombolytic therapy has become standard treatment for some patients with acute myocardial infarction.

Adult↗
PubMed1989

[Surgery of congenital cardiopathies without previous catheterization. Preoperative evaluation and surgical indication using bidimensional echocardiography and Doppler].

With the non-invasive devices available nowadays, many congenital heart diseases may be diagnosed with a definition comparable and even perhaps superior to catheterization and angiography. According to this issue, from January 1983 to December 1987, 239 children underwent operations for palliation or correction of different cardiopathies based on an echo-Doppler assessment without prior catheterization. Preoperative echo-Doppler diagnoses had an adequate correlation with the surgical findings in 234 cases (97.9 percent), so there was no correlation in 5 cases. In general, we consider that echo-Doppler provides a complete and definitive diagnosis in most cases, thus eliminating the need for further invasive procedures, although we still have to rely on catheterization to obtain the necessary information or reassurance in some cases. Progressive increase of reliance in echo-Doppler techniques by the surgeon and self confidence of the cardiologist in his accurate state of the art will considerably increase the performance of cardiac operations without prior catheterization in the future. At present, this is our current policy, as day after day, we are increasing the diagnoses in which we consider unnecessary the catheterization to indicate surgery.

Adolescent↗
PubMed1977

Hemodynamic and angiocardiographic changes following nitroglycerin in coronary artery disease.

33 patients with suspected coronary artery disease were studied hemodynamically and angiocardiographically in the resting state and following administration of 0.4 mg of sublingual nitroglycerin (NTG). After NTG several parameters were changed: LVEDP, mean LV systolic pressure, EDVI, ESVI, SVI and SWI were decreased; EF, mean Vcf, MNSER, heart rate (P less than 0.01; r = 0.801) and chords, hemichords and shortening of long axis were increased. However, the changes after NTG were markedly different in patients with diffuse and localized LV asynergy, suggesting a more important inotropic effect of NTG in patients with localized LV asynergy, while reduction in venous return and EDV would be the main effect of NTG in patients with diffuse LV asynergy.

Adult↗
PubMedDate not supplied

[Complete atrioventricular canal and tetralogy of Fallot: surgical considerations].

Nine patients with complete atrioventricular canal and tetralogy of Fallot underwent intracardiac repair of both anomalies between 1982 and 1989. The ages of the patients ranged from 6 months to 7 years. Six of the 9 had one or more previous systemic-pulmonary artery shunts. Two-dimensional echocardiography showed diagnostic characteristics of both malformations in all patients. The diagnosis was confirmed by cardiac catheterization and cineangiography. The ventricular septal defect was repaired by a combined right atrial and ventricular approach in every patient. Outflow tract reconstruction was performed with the use of a transannular patch (4), infundibular patch (4), and a valved conduit (1). There were no hospital deaths. Meningitis was responsible for the death of a patient 2 years after repair. We recommend early palliation, complete repair in those older than 4 or 5 years, surgical technique depending on the anatomical findings, combined atrial and ventricular approach, 2 separate patches to close the ventricular septal defect in required cases, adjusted correction of the right ventricular outflow tract, and careful postoperative care.

Child↗