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Biomedical subjects

R Ibáñez

Publications and source records attributed to R Ibáñez.

At least 19 recordsLinked to original sources
PubMed2003

[Fluctuations and dyskinesias as early L-dopa-induced motor complications in severe Parkinsonian's patients].

Daily fluctuations of motor performance and dyskinesias in patients with Parkinson's disease (PD) treated with levodopa represent a difficult challenge to our understanding. We report 10 patients diagnosed of severe PD (Hoehn and Yahr: III-IV/V) treated with levodopa (range of dose: 750-900 mg/day) in single drug therapy since their diagnosis (mean time of levodopatherapy: 4.8 2.4 months, range: 3-6 months). All patients developed motor complications within weeks to months after initiating L-dopatherapy. Two patients received an intravenous apomorphine infusion (mean dose: 8.5 mg/day) during a mean time of 7.5 hours, but motor complications persisted during the infusion in spite of continuous dopaminergic stimulus. The degree of nigrostriatal damage (disease severity) seems to be a very important risk factor for the development of treatment-related motor complications.

Aged↗
PubMed2003

[Bone mineral density measurement techniques].

Different techniques for measuring bone mass density developed in the last years are revised. Single and dual fotonic absorciometry are now outdated by the use of single and dual x-ray absorciometry which don't need an isotope source. The most widely used technique now is the dual energy x-ray asbsorciometry, specially the ones who analyse lumbar spine and hip. It is an accurate and precise tool and has proved to be a good predictor of fractures. Nevertherless, peripheral densitometers based on dual energy x-ray or on broadband ultrasonic attenuation, have also proved to be of utility. Quantitative computed tomography is the only three-dimensional densitometer available, capable to selectively measure cortical or trabecular bone. It has the inconvenient of the high radiation and cost. We argue about advantages and disadvantages of the different techniques of bone mass measurements.Lastly, we revise the indications of densitometry. There are not unanimous criteria about this question, but different organisms and scientific societies have elaborated recommendations based on risk factors of osteoporosis and fracture, that could be of utility in clinical practice.

Absorptiometry, Photon↗
PubMed2001

[Motor impairment, in patients with severe Parkinson's disease, associated with dopaminergic hyperstimulation (entacapone)].

OBJECTIVE: [corrected] Entacapone was given to try to improve the motor complications in eight patients with Parkinson's disease (PD) treated chronically with levodopa, with daily severe motor fluctuations and dyskinesias. PATIENTS AND METHODS: We introduced entacapone (200 mg added to every dose of levodopa) to 8 parkinsonian patients (mean age: 68.25 +/- 2.3; range: 68-72; mean PD duration: 10.4 +/- 2.7 years) treated with oral levodopa, plus a dopa-decarboxylase inhibitor (mean dose: 706.25 +/- 2.3 mg/day; mean period of levodopa-treatment; 9 +/- 2.3 years). Dyskinesias were present in all patients (chorea: 8 patients; "off"--dystonia: 4; byphasic dyskinesias: 3). The type and duration (time "on" and "off") of fluctuations was categorized on the "on-off" charts drawn up by the patients or their relatives, and observation by the investigators after the introduction of entacapone. One patient, with severe impairment with entacapone, was evaluated (motor response) during i.v. apomorphine infusion (40 mg, during 3 hours). RESULTS: The combination of levodopa and entacapone was associated with a net increase in "off" time in all patients (from 5.8 +/- 1.2 h to 12.4 +/- 4.4 h) without change in the URPD. In the patient studied with i.v. apomorphine, "off" periods appeared during the infusion. CONCLUSION: These findings suggest that increased daily levodopa consumption may reduce striatal responsiveness to dopaminergic stimulation in severe parkinsonian patients. These data should be considered when planning the treatment strategy of complex parkinsonian patients.

Aged↗
PubMed2000

Characterisation and management of incinerator wastes.

Management of municipal and hospital wastes by means of incineration processes generates solid residues, such as bottom and fly ashes and air pollution control residues with high content of heavy metals, inorganic salts and other organic compounds. Characterisation of 24 ash samples, collected from four municipal solid waste incinerators (MSWI) and six hospital medical waste incinerators (HMWI) located in the Basque Country Region (Northern Spain), were carried out at the request of Spanish Regulations and European Economic Community guidelines. The ecotoxicity values, EC(50), of the TCLP leachates show a high variability ranging from 12,967 to 1,000,000mgl(-1) in MSWI samples and from 2917 to 333,150mgl(-1) in HMWI samples. Results from chemical characterisation of DIN 38414-S4 leachates show a high concentration of lead, sulphate and chloride in MSWI samples and chromium in HMWI samples.

Air Pollutants↗
PubMed1999

Pancreatic infection with Candida parapsilosis.

Candida species other than C. albicans have been implicated as pathogens in intravascular (bloodstream, intravascular devices, endocarditis) and extravascular (arthritis, osteomielitis, endophtalmitis) infections. C. parapsilosis, however, is rarely implicated in intra-abdominal infections (peritonitis during peritoneal dialysis, complicating surgery or solid-organ transplantation). We describe a case of a 48-y-old male with acute pancreatitis who had a pancreatic abscess produced by primary C. parapsilosis infection. Although he received adequate treatment with antifungal medication and surgical drainage, the outcome was fatal. Because the clinical findings are indistinguishable from bacterial abscesses, Candida species should be considered in cases of complicated pancreatitis, in order to establish a prompt adequate treatment.

Abscess↗
PubMed1999

Bacteremia caused by digestive system endoscopy.

AIM: to evaluate bacteremias caused during endoscopic examination of the digestive tract. PATIENTS AND METHODS: prospective study of randomly selected patients who underwent digestive system endoscopic examination. Emergency endoscopic examinations were excluded. RESULTS: a total of 102 patients were analyzed. Of 44 patients who underwent gastroscopy, 11 (25%) subsequently had positive blood culture, and Staphylococcus spp and Streptococcus spp were isolated. Of 30 patients who underwent colonoscopy, 3 (10%) had positive blood cultures, and Staphylococcus spp were isolated. Of 28 patients who underwent endoscopic retrograde cholangiopancreatography, 11 (39.2%) had positive blood cultures, and Escherichia coli, Morganella morganii, Staphylococcus spp and Streptococcus spp were isolated. No deaths, endocarditis or other septic phenomena were attributed to bacteremia. CONCLUSIONS: the incidence of bacteremia ranged from 10% to 39% depending on the type of endoscopy. The microorganisms that were isolated most frequently were Staphylococcus spp and Streptococcus spp. Gram-negative bacilli and enterobacteria were isolated in patients who had undergone endoscopic retrograde cholangiopancreatography.

Adolescent↗
PubMed1997

Elastic structures in the vocalization apparatus of the Túngara frog Physalaemus pustulosus (Leptodactylidae).

Histological analysis of the vocal sac and body wall in the leptodactylid frog Physalaemus pustulosus suggests that both muscle and elastic fibers are important in call production. Abdominal musculature as well as abdominal bands of elastin (the lineae masculinae) provide the energy required for exhalation and sound production. Air flowing through the larynx inflates a highly extensible vocal sac lined with muscle and a network of elastic fibers. Inherent elasticity together with muscular activity of the vocal sac likely increase the speed and possibly decrease the energetic costs of lung reinflation following vocalization. The mechanics of call production in P. pustulosus thus involve not only laryngeal activation but also elastic transfer of air between the supralaryngeal vocal sac and abdominal respiratory structures.

Abdominal Muscles↗
PubMed1993

[Current situation of dominant autosomal renal polycystosis].

Adult onset polycystic kidney disease causes 11% of all end-stage renal disease in Spain. Recent advantages in the molecular genetics of autosomal dominant polycystic kidney disease (ADPKD) point the way towards the cloning and decoding. One of the gene loci, namely PKD1, was located to the short arm of chromosome 16. Recombinants between 16p polimorphic loci and the PKD1 locus are described. The clinical consecuents of ADPKD are analyzed. Hypertension arterial are found more frequent in the those patients. Caution is therefore recommend in using ACE inhibitors who are at high risk because of compromised renal function. Our study clarifies several clinical extrarenal manifestations of ADPKD. All modalities of renal replacement therapy are appropriate therapeutics choices.

Humans↗
PubMed1990

Non-genomic mechanism of action of delta-4 and 5-reduced androgens and progestins on the contractility of the isolated rat myometrium.

Effective concentrations50 of androgens, i.e. testosterone, androsterone, androstanediol, 5 beta-dihydrotestosterone and progestins: progesterone, pregnanolone, pregnanedione, epipregnanolone, allopregnanolone and allopregnanedione were assayed on the tonic contractions of the isolated rat myometrium induced by calcium in high-potassium calcium-free depolarizant solutions. Steroids showed their relaxant effect by fadding the sustained contraction induced by calcium in a depolarized state. Also, the addition of the calcium ionophores A-23187 and X-537A reversed the steroid relaxant effect by increasing sharply the tonic contraction. The possibility of steroid-induced relaxation through release of noradrenaline or histamine was discarded by blocking their specific receptors. From the results it is concluded that delta-4 and 5-reduced androgens and progestins produce relaxation by a myogenic mechanism acting on the smooth muscle cell, most likely by directly blocking the calcium channels they causing modulation of: the contraction-relaxation cycle.

Androgens↗