PubMed Health⌕ Search

Biomedical subjects

R Núñez

Publications and source records attributed to R Núñez.

At least 19 recordsLinked to original sources
PubMed1997

Parenteral administration of different amounts of branch-chain amino acids in septic patients: clinical and metabolic aspects.

OBJECTIVE: To study the effects of a total parenteral nutrition solution changing branch-chain amino acid concentrations and/or nitrogen supply on protein metabolism, length of stay, and mortality rate; and to evaluate the unique metabolic status of sepsis that leads to a search for specific total parenteral nutrition formulas. DESIGN: Prospective, randomized, and multicenter study. SETTING: Intensive care units (ICUs) in seven university hospitals. PATIENTS: Sixty-nine septic patients. MEASUREMENTS AND MAIN RESULTS: The patients were randomized into three groups according to the total parenteral nutrition administered. Group A (n = 22) and B (n = 25) patients received 1.5 g of amino acids/kg/day with a nonprotein ratio of 100:1 calories/g of nitrogen, and a varying branch-chain amino acids percentage (group A [23%); group B [45%]). Group C patients were treated with 1.1 g/kg/day of amino acids with a nonprotein ratio of 140:1 calories/g of nitrogen and 45% branch-chain amino acids. All diets were isocaloric. Prealbumin, retinol-binding protein, nitrogen balance, and plasma amino acid profiles (24 amino acids) were determined at baseline and after 3, 7, and 11 days of total parenteral nutrition. The length of stay and the mortality rate in the ICU were recorded. At baseline (preparenteral nutrition), no differences in age, gender, severity of the condition, or clinical chemistry were found between the groups. Prealbumin and retinol-binding protein increased in groups B (p < .004, p < .002, respectively) and C (p < .001, p < .002, respectively). Plasma arginine increased significantly in group C (p < .05), and plasma valine (p < .0001, p < .04, respectively), leucine (p < .005, p < .03, respectively), and isoleucine (p < .001, p < .0001, respectively) increased significantly in groups B and C. The length of stay in the ICU did not change between the groups. The mortality rate in groups B and C was less than in group A (p < .03). CONCLUSIONS: Our results suggest that the branch-chain amino acids-rich formulas (45%) show a beneficial effect in septic patients.

Amino Acids↗
PubMed1997

[Pancreatic pseudocyst. Review of 22 cases].

The management of 22 children with pseudocyst of the pancreas presenting over a 15-year period at three pediatric Hospitals is reviewed. The mean age of patients was 7 years being more common in boys (17:5). Ninety one per cent were due to trauma, while in 9% the cause was unknown. Vomiting (81.8%), abdominal pain (77.2%), a mass (72.7%), fever (31.8%) and anorexia (31.8%) were the most frequent findings. The diagnosis was confirmed by finding hyperamylasemia (elevated in 72.7% of cases), by barium meal and ultrasound. Operative treatment included external drainage in 4 children, cystgastrostomy in 9, cystjejunostomy in 6, and excision in 1. One patient was successfully managed nonoperatively and another had spontaneous gastric drainage. There were no deaths or significative complications in this series.

Abdominal Pain↗
PubMed1996

Idiopathic eosinophilic synovitis. Case report and review of the literature.

Eosinophilia of synovial fluid is an uncommon condition. The majority of the reported cases are associated to diseases such as rheumatoid arthritis, parasitic disease, hypereosinophilic syndrome, Lyme disease, and allergic processes as well as hemarthrosis and arthrography. Presently there are only four cases of eosinophilic synovitis with unknown cause. We are reporting a patient with oligoarthritis of the knees, massive eosinophilia, and Charcot-Leyden crystals in synovial fluid without associated cause. We review the clinical and biological features of eosinophilic synovitis and discuss its pathogenesis.

Adolescent↗
PubMed1996

[Effects of several methods of thoracic drainage on respiratory function].

UNLABELLED: The object of this study was to verify the influence on the pulmonary function of the pleural space ampliation with pleural drainage tube underwater seal, with several volumes or with variables negative pressures. We performed 42 New Zealand white rabbits of both sexes with an average age of 57 +/- 9.31 days and an average weight of 1720 +/- 181 g. The experimental protocol consisted of study group: P1 (n = 14) was performed a unilateral thoracostomy at the 5th. Intercostal space and P2 (n = 14) with bilateral pleural drainage. The pleural drainage tube (drain trocart ORX Vygon number 8) connected at small bottle (Fp), with 35 ml of extrapleural volume and at big bottle (FG) with 3940 ml of extrapleural volume and vacuum suction of various negative pressures (-5, -10, -15 and -20 cm H2O). CONTROL GROUP: C1 (n = 7) with unilateral pleural drainage clamped and C2 (n = 7) with bilateral pleural drainage clamped. Anesthesia was induced with ketamine hydrochloride (7.5 ml/Kg) and propionilpromazyne (1.5 ml/Kg) intramuscular cocktail and after maintained with bolus injection of 1/4 induction dose. We studied the mortality, the the fluctuations of drain hydrostatic column, heart rate (FC), respiratory rate (FR) and blood gas tensions, after cannulation of right jugular vein and during the different phases of experimental design. Venous blood samples were obtained for pO2, pCO2 and pH measurements were repeated at 5' in both groups. The 50% of animals died in the P2 group during the drainage pleural of FG. The fluctuation of column of Fp was similar in both groups: P1 = 6.39 +/- 1.0, with a decrease of 0.64 +/- 0.23 and P2 = 6.37 +/- 1.29, with a decrease of 0.63 +/- 0.28, respectively. The vacuum suction of pleural cavity may produce a FR fall which recovery fast. The bilateral pleural drainage with negative pressures produced decreases of pCO2 and pO2. There is not modifications of Acid Base Balance in the experimental groups. We concluded that during bilateral pleural underwater seal connected a FG, because the increase of extrapleural space may produce a high mortality and a fall of respiratory rate with fast recovery. Also the pleural suction improved the CO2 diffusion into the alveolus. There is not modifications of pO2 in P1 group or decrease in the P2 group.

Animals↗
PubMed1995

Comparative neurotransmitter reuptake and anticholinergic potencies of the 8-hydroxy metabolites of clomipramine.

We hypothesize that 8-hydroxy-clomipramine (8-OH-CMI), the major hydroxy metabolite of clomipramine (CMI), may have antidepressant properties with less anticholinergic potency than CMI. We compared the potencies of 8-OH-CMI and CMI for inhibition of serotonin and norepinephrine reuptake and the potencies of these compounds for blockade of muscarinic receptors. We also compared the antimuscarinic potencies of desmethylclomipramine (DCMI) and 8-hydroxy-desmethylclomipramine (8-OH-DCMI). We found that 8-OH-CMI inhibits the uptake of serotonin and norepinephrine to the same extent as CMI and that 8-OH-CMI has far less antimuscarinic potency than CMI. We also found that 8-OH-DCMI has about one-tenth the antimuscarinic potency of DCMI. Since the therapeutic efficacy of CMI may be related to its effect on the reuptake of neurotransmitters, and since the extent of clinical anticholinergic effects of tricyclic antidepressants has been shown to be related to their in vitro antimuscarinic potencies, these results raise the possibility that 8-OH-CMI may be an analogue of CMI with fewer anticholinergic side effects than the parent compound.

Animals↗
PubMed1995

[Transitional cell papilloma of the ureter causing uretero-hydronephrosis in a child].

A case of transitional cell papilloma of the ureter is reported in a seven-year-old boy who had a history of left flank pain, involuntary voiding and nocturnal enuresis, and was found to have ureterohydronephrosis of a solitary left kidney and renal insufficiency. Renal function and morphology were restored by cutaneous loop ureterostomy, neoureterocystostomy and ureterostomy closure in a staged repair.

Child↗
PubMed1995

[Epidermoid cysts of the spermatic cord].

We report two cases of epidermoid cyst of the spermatic cord in infants 14 months and 2 1/2 years old, respectively. The initial diagnosis in one patient was funicular hydrocele and paratesticular mass no transilluminable in the other case. The treatment was the local excision of tumor and the diagnostic was histological in both patients. Postoperative course was excellent in both, the first after fistullization and surgical treatment. Must be explored the transillumination of the mass which would have led us to think other of the diagnoses different from that of the cord hydrocele before the operation, since it would have given negative. During the operation, must be assured that the cystic anomaly is limited to spermatic cord, to evite fistulization in the postoperative course.

Child, Preschool↗
PubMed1994

Volatile anesthetics decrease peristalsis in the guinea pig ureter.

BACKGROUND: The origin of renal dysfunction associated with anesthesia and surgery is complex and incompletely understood. The effects of the volatile anesthetic agents isoflurane, enflurane, and halothane on the renal pacemaker and ureteral peristalsis may play an important role. METHODS: Guinea pig ureter and pelvis were dissected and placed in a sample chamber that allowed immersion in a temperature-controlled bath with gas (O2 with or without volatile agent) bubbled through the chamber continuously. The baseline frequency and amplitude of peristaltic contractions were measured on a polygraph recorder. The preparations were then exposed to up to 4 vol% volatile agent incrementally to generate a cumulative dose-response curve, and the subsequent frequency of peristaltic contractions was determined. The concentration of the volatile agent in solution was measured by gas chromatography. RESULTS: There was a significant dose-related decrease in the frequency of ureteral contractions for all three agents. A statistical model relating percentage baseline frequency to millimolar concentrations of volatile anesthetics showed that halothane produced a more pronounced decrease in frequency than did isoflurane or enflurane. However, the decrease was directly related to the MAC multiples and did not differ for the three agents. CONCLUSIONS: Ureteral peristaltic contractions are decreased in a dose-dependent manner by enflurane, halothane and isoflurane.

Animals↗
PubMed1993

A lipid-anchored heparan sulfate proteoglycan is present in the surface of differentiated skeletal muscle cells. Isolation and biochemical characterization.

We have investigated the presence of hydrophobic membrane-associated heparan sulfate proteoglycans (HSPG) on the cell surface of differentiated skeletal muscle cells. A HSPG releasable by incubation with a phosphatidylinositol-specific phospholipase c (PtdIns-PLC) was obtained. HSPG were also isolated from Triton X-100 extracts of the cells. The hydrodynamic characteristics of the PtdIns-PLC-releasable and detergent-extracted HSPG were indistinguishable. SDS/PAGE analysis of the PtdIns-PLC-releasable HSPG indicated a molecular mass of 250 kDa. Analysis of proteins immunoprecipitated by specific antibodies against a HSPG isolated from Schwann cells demonstrated that the antisera precipitated an intact HSPG that was present in the pool of proteins released by PtdIns-PLC and by Triton X-100 from [35S]sulfate labeled cells. Nitrous acid degradation of the immunoprecipitated proteins released by PtdIns-PLC from [35S]methionine labeled cells produced a single 67-kDa core protein. Analysis of hydrophobicity of the purified HSPG revealed that only the HSPG obtained from the detergent extract were able to be incorporated into the liposomes whereas the PtdIns-PLC-released HSPG was not. Immunocytolocalization analysis of the differentiated cells indicated that the PtdIns-PLC-releasable HSPG was located on the cell surface. Prior incubation of the cells with PtdIns-PLC significantly reduced the surface staining. Analysis of skeletal-muscle sections of adult rat skeletal muscles indicated that this HSPG localized exclusively at the endomysium. This localization suggest that these HSPG may be acting as a cell receptor for extracellular-matrix (ECM) components.

Animals↗
PubMed1993

Congenital diaphragmatic hernia and intrathoracic intestinal volvulus.

The main symptom of the congenital diaphragmatic hernia (CDH) is the respiratory distress due to the pulmonary hypoplasia and the persistence of foetal pulmonary circulation. Sometimes the CDH appears outside of the neonatal period with respiratory symptoms, abdominal pain and seldom with intestinal obstruction. A case of CDH presenting with intrathoracic volvulus is reported. This case shows that tendency of delayed repair until the newborn has been recovered, require more attention because the good condition of the patient can be changed not only by the pulmonary hypoplasia and the persistence of the foetal pulmonary circulation but also by the symptoms of the intrathoracic gut complications.

Diaphragm↗
PubMed1993

[Neonatal hepatocholecystectomy because of an incarcerated umbilical hernia].

Two newborns are described, both with a hernia of the umbilical cord, which contained a piece of liver and gallbladder united to the normal liver by a thin pedicle. One of them showed typical features of Beckwith syndrome. In one patient the gallbladder was removed together with the accessory liver lobe, in the other, the accessory liver lobe was excised, and the gallbladder replaced into the abdominal cavity.

Cholecystectomy↗
PubMed1993

[Anorectal manometry in the newborn].

Anorectal manometry was performed in 32 newborn. There were 18 preterm and 14 fullterm infants, mean ages 6.1 and 7.1 days respectively. The rectoanal inhibitory reflex (RIR) was positive in 31 of the newborn, and the relaxation waves produced by rectal distention were recorded along the anal canal and were directly correlated to intensity of the stimulus. In the remaining patient RIR was negative, due to Hirschsprung's disease, confirmed at surgery. The length of the anal canal was 10.3 +/- 2 mm. in preterm newborn infants and 14.7 +/- 2.9 mm, in fullterm (p < 0.0001). These findings suggests that presence of RIR is independent of the weight, gestational age and birth age of the infant, and that anal canal length is correlated with the weight of the infant. We conclude that anorectal manometry, in the neonatal period, is a simple, reliable and safe method to test anorectal functionality, including the study of Hirschsprung's disease.

Female↗
PubMed1993

[Myringoplasty. . 5-year study on the anatomic and functional results].

The AA. consider both anatomical and functional results with the "on-lay" procedure for closure of central tympanic perforations in 131 cases, treated at their Department in a 5 years term. They report the end conditions pointing out several parameters implicated as type and size of the perforation, anesthetic used, source of the graft and surgical approach. Finally they confront the anatomical and the functional results. The aim of the paper is to emphasize the value of the procedure followed in the attempt of re-stablishing the integrity of the ear drum.

Adolescent↗
PubMed1993

[Complications of phonatory fistuloplasty. Case report].

The paper deals with a severe mediastinal complication when performing, in a laryngectomee, a secondary fistuloplasty. Brief review of possible failures of this surgery, which are not common, but sometimes can be severe and even deadly.

Carcinoma, Squamous Cell↗
PubMed1992

[Orthotopic liver transplantation in the Budd-Chiari syndrome. A case report].

A patient with Budd-Chiari's syndrome of idiopathic etiology, received an emergency liver transplant because of terminal liver insufficiency, including encephalopathy, functional renal failure and progressive deterioration of coagulation. The diagnosis was confirmed by biopsy. The transplanted liver was from a patient with the same blood group and the preserving solution was Euro Collins. No veno-venous by-pass was necessary during operation. Anticoagulation was started from the immediate post-operative stage, as well as triple immunosuppressive therapy with azathioprine, cyclosporine and corticoids. The patient is asymptomatic twenty months after transplantation.

Adult↗
PubMed1990

Changes in the number of leukocytes and lymphocyte subpopulations induced by exercise in sedentary young people.

The influence of physical exercise on the quantification of leukocytes and lymphocyte subpopulations has been studied. These cells were obtained from blood taken from eleven healthy young men and women who follow a sedentary life style, before and after vigorous exercise (running). The results indicate that physical activity increases the number of white blood cells and the concentrations of circulating lymphocytes. The proportion of T-lymphocytes, estimated as rosette forming cells with sheep red blood cells after cold incubation, is constant, whereas a corresponding increase in cells with receptors for C3b or Ig-Fc is also observed. The data indicate that physical activity leads to an irregular intravascular discharge in stored cells.

Adult↗