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P Robles

Publications and source records attributed to P Robles.

26 records · Page 2Linked to original sources
PubMed1997

[Biventricular diverticulosis associated with rheumatic heart disease: apropos of a case].

We report a case of a 58-year-old woman with rheumatic mitral stenosis scheduled for percutaneous valvuloplasty. Prior left and right ventricular angiograms showed multiple diverticula at left ventricular apical and diaphragmatic walls and right ventricular diaphragmatic wall. Chest x-ray and echocardiogram were normal. Magnetic resonance imaging was concordant with catheterization findings and ruled out other cardiac malformations. The risk of ventricular perforation changed our indication of percutaneous valvuloplasty in favor of open heart commissurotomy.

Cardiac Surgical Procedures↗
PubMed1996

Risk factors associated with drug-resistant Mycobacterium tuberculosis in Castilla-la-Mancha (Spain)

The aim of this study was to investigate the incidence of primary and secondary resistance to antituberculosis drugs and the risk factors associated with the resistance in southeast Spain. Our research was based on the clinical histories of 276 patients, diagnosed as having tuberculosis by positive culture, who were tested for drug susceptibility between January 1988 and October 1994. The clinical histories were checked by two independent investigators. Drug-resistant strains were isolated from 24 patients (8.7%). Among the 239 patients without previous tuberculosis therapy, 7 (2.9%) were drug-resistant. Among the 37 patients with previous therapy, 17 (46%) were drug-resistant. Seventeen of the 276 patients (6.2%) had resistance to a single drug. Primary resistance to isoniazid was 1.7%. Previous treatment for tuberculosis (odds ratio (OR) 39.2; 95% confidence interval (95% CI) 10.2-150); hepatic cirrhosis (OR 104; 95% CI 12.8-847); and age 45 yrs and older (OR 4.80; 95% CI 1.15-20.1) were considered risk factors associated with drug-resistant tuberculosis. We conclude that primary and secondary resistance is low in the southeast of Spain and we recommend that susceptibility testing be performed on initial M. tuberculosis isolated from patients with a history of previous tuberculosis therapy, hepatic cirrhosis or more than 44 yrs of age.

Adolescent↗
PubMed1995

[Aortic prosthetic endocarditis and periprosthetic abscess caused by Staphylococcus aureus].

Prosthetic endocarditis with annular abscess formation is a severe complication of cardiac valve replacement fortunately uncommon, though highly lethal. Increasing surgical experience and the high mortality with medical management have led to a widespread recommendation for early prosthetic replacement. We report a case of a 49 year old man with infective endocarditis due to Staphylococcus aureus in aortic ascendens prosthetic and aortic valve prosthetic complicated with periaortic abscess which was as successful treatment by drain of abscess without prosthetic replacement.

Abscess↗
PubMed1995

Mitral annular calcification in CAPD patients with a low degree of hyperparathyroidism. An analysis of other possible risk factors.

Chronic renal failure has been suggested as a risk factor for mitral annular calcification (MAC), a degenerative process of the mitral annulus. The objective of the present study was to define MAC risk factors at the start of dialysis and 'de-novo' appearance after medium- or long-term CAPD, in a non-selected population (135 patients) with a low degree of secondary hyperparathyroidism. Echocardiographic studies were performed at the beginning of CAPD and every 1-1.5 years thereafter. Diagnosis of MAC was established by M mode and 2-D study. Seventeen of 135 patients studied at the start of dialysis showed MAC. Patients who showed MAC were older and presented a higher mean systolic blood pressure. The other anthropometric/demographic parameters did not show statistically significant differences. MAC thickness: mean 6.21 +/- 3.65 mm (range 3-17.2 mm). The posterior annulus was universally affected and in four patients the anterior annulus was involved. Seventeen of 76 patients included in the follow-up study developed MAC. No significant differences for demography, except age, with MAC patients being older, were found. Mean time on CAPD until de-novo MAC diagnosis was 49.7 +/- 26.9 months. MAC thickness: mean 4.97 +/- 1.6 mm (range 3-8.42 mm). The posterior annulus was affected in all patients except for one and in four patients the anterior annulus was involved. The most remarkable echocardiographic feature is the almost constant association of MAC with left atrial dilatation (LAD). The last one does not seem a consequence of mitral insufficiency, or systolic dysfunction. Left ventricular hypertrophy was universally found, with no different intensities for patients with or without MAC. In conclusion, a high incidence of mitral annular calcification has been found in CAPD patients. Our data do not confirm the role of classical invoked risk factors. Blood CaP product under 75, a moderate to mild degree of hyperparathyroidism and/or hypertension with left ventricular hypertrophy do not seem to be isolated risk factors during the CAPD period. Length of time on CAPD, for unknown reasons, seems to favour the appearance of MAC. At starting dialysis, high systolic blood pressure and left ventricular hypertrophy seem to be related to MAC. Diabetes appears to represent an additional risk factor. Further research on mitral annular calcification pathogenesis and its consequences is urgently required.

Calcinosis↗
PubMedDate not supplied

[Design of a program of quality control of nursing in an intensive care unit].

Although in the last few years care quality programs have started to be used in services, these are still few in nursing equipment. Our aim is to show the process we have followed to design a nursing care quality program in ICU. We developed the stages of process, where a list of general activities performed in the service was created to establish a priority later, as it was necessary, due to the high number of aspects or activities to monitor, to choose those we would use to start the quality control program. The ultimate order was settled with the following activities: 1. Surveillance of the infection. 2. Accidental withdrawal of tubes and catheters. 3. Pressure ulcers.

Humans↗