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Biomedical subjects

R Sosa

Publications and source records attributed to R Sosa.

At least 19 recordsLinked to original sources
PubMed2002

Sequential treatment with bolus and continuous infusion of recombinant factor VIIa for hip arthroplasty in a patient with haemophilia A and inhibitor.

We describe a total arthroplasty of the hip in a 40-year-old male patient with haemophilia A and a high-titre inhibitor to factor VIII, treated with rFVIIa. The patient received sequential therapy first as bolus in the early postoperative phase in order to obtain appropriate haemostasis and then as continuous infusion with lower doses to avoid frequent episodes of bleeding without a higher consumption of product. After an initial dose of 150 micro g kg-1 for the first five days after surgery, we used bolus doses of 120-90 micro g kg-1 every 2.5-3 h, achieving plasma FVII:C levels above 40 U mL-1. We then continued with continuous infusion at decreasing doses 15-7 micro g kg-1 h-1 for 12 days (FVII:C 19-7 U mL-1). There were no bleeding complications nor signs of clotting activity. The rehabilitation programme was continued without prophylactic treatment. The total consumption of rFVIIa was 6.3 mg kg-1, implying a saving of at least 30% of the product with respect to previous publications.

Adult↗
PubMed2001

Growth of preterm infants fed nutrient-enriched or term formula after hospital discharge.

OBJECTIVE: At hospital discharge, preterm infants may have low body stores of nutrients, deficient bone mineralization, and an accumulated energy deficit. This double-blind, randomized study evaluated the growth of premature infants with birth weights <1800 g who were fed a 22 kcal/fl oz nutrient-enriched postdischarge formula (PDF) or a 20 kcal/fl oz term-infant formula (TF) from hospital discharge to 12 months' corrected age (CA). METHODS: Infants were randomized to PDF or TF a few days before hospital discharge with stratification by gender and birth weight (<1250 g or >/=1250 g). The formulas were fed to 12 months' CA. Growth was evaluated using analysis of variance controlling for site, feeding, gender, and birth weight group. Interaction effects were also assessed. Secondary analyses included a repeated measures analysis and growth modeling. RESULTS: One hundred twenty-five infants were randomized; 74 completed to 6 months' CA and 53 to 12 months' CA. PDF-fed infants weighed more than TF-fed infants at 1 and 2 months' CA, gained more weight from study day 1 to 1 and 2 months' CA, and were longer at 3 months' CA. There were significant interactions between feeding and birth weight group-among infants with birth weights <1250 g, those fed PDF weighed more at 6 months' CA, were longer at 6 months' CA, had larger head circumferences at term 1, 3, 6, and 12 months' CA, and gained more in head circumference from study day 1 to term and to 1 month CA. The repeated measures and growth modeling analyses confirmed the analysis of variance results. The PDF formula seemed to be of particular benefit for the growth of male infants. Infants fed the PDF consumed less formula and had higher protein intakes at several time points. Energy intakes, however, were not different. CONCLUSIONS: Growth was improved in preterm infants fed a nutrient-enriched postdischarge formula after hospital discharge to 12 months' CA. Beneficial effects were most evident among infants with birth weights <1250 g, particularly for head circumference measurements.

Aftercare↗
PubMed1996

Characterization of Trypanosoma cruzi populations by zymodemes: correlation with clinical picture.

Trypanosoma cruzi isolated from 55 chronic chagasic patients were grouped into isozymic strains on the basis of electrophoretic patterns for a set of six enzymes. The total sample showed a distribution of asymptomatic (63.6%) and clinically ill (36.4%) patients similar to that generally reported for Chagas' disease. Six of the 12 zymodemes known to exist in Argentina have been isolated from humans. Only two (Z1 and Z12) are frequent and widely distributed in the endemic area. These two zymodemes differ significantly in their pathogenicity. The proportion of asymptomatic patients was higher with the Z1 zymodeme (81.1%) than with the Z12 zymodeme (27.3%). The incidence of heart alterations was lower in Z1 than in Z12 zymodeme patients (18.9% versus 72.7%). Clinically evident acute disease was seen in 36.3% of cases with zymodeme Z12 and in 8.1% of cases with zymodeme Z1. The differences between the two prevalent zymodemes in Argentina are statistically significant. These observations indicate that the Z1 T. cruzi is a more benign strain than Z12. Patients infected with Z1 would be more likely to be asymptomatic for a longer time than those infected with Z12. The risk of cardiac lesion would be greater for patients harboring Z12 T. cruzi than for those with Z1. The results suggest that strain identification could be a useful prognostic tool.

Acute Disease↗
PubMed1995

Threshold retinopathy of prematurity. Transition from cryopexy to laser treatment.

PURPOSE: The authors studied the effectiveness of laserpexy versus cryopexy for treatment of acute retinopathy of prematurity. METHODS: Seventy-six eyes in 41 patients were treated for acute retinopathy of prematurity from January 1991 to April 1994. RESULTS: Fifty-six eyes in 30 patients had zone 2 disease. Of these 30 patients, 11 received laser treatment and 20 received cryopexy treatment; there was at least one anatomically successful eye in each patient. Twenty eyes in ten patients had zone 1 disease. Seven patients had bilateral laser treatment. Three patients had bilateral cryopexy. In seven eyes with zone 1 disease, five were treated successfully with laser. None of the three eyes with zone 1 disease treated with cryopexy were successful. CONCLUSION: Laserpexy and cryopexy are of equal efficacy in treating zone 2 disease. There is a tendency that suggests that laserpexy is more effective than cryopexy in treating zone 1 disease. Diode and argon lasers are of equal efficacy in treating zone 1 disease.

Acute Disease↗
PubMed1995

[A new case of congenital leukemia with leukemia cutis].

Congenital leukaemia is a condition occurring very rarely. In a recent review in 1993, 175 cases are reported, 25-30% of them being well documented as leukaemia cutis. We reported a new case of congenital leukaemia diagnosed as an acute non lymphoblastic leukaemia M4 (FAB) and diagnosed at birth. It involves a newborn female at 42 weeks of gestational age. The most relevant clinical features were hepatomegaly and cutaneous petechial lesions along with a generalized distribution of nodules. From the blood peripheral count, leukocytosis is observed (177 x 10(9)/L) with 48% blasts of myeloid immunophenotype. The coagulation studies were consistent with a disseminated intravascular coagulation syndrome. A biopsy carried out on a cutaneous nodule, revealed diffuse dermoepidermic infiltration by immature cells of myeloid lineage, with cellularity and count similar to that of bone marrow and peripheral blood. The karyotype in the peripheral blood was normal. Infectious and immune causes were excluded as well as constitutional illnesses associated with unstable haematopoiesis. The family rejected treatment with chemotherapy and the baby died on day 53 of life due to progressive leukocytosis and concurrent infection. Our case, like 80% of the cases reported, is of myeloid origin and confirms the fatal evolution of untreated congenital leukaemia.

Diagnosis, Differential↗
PubMed1994

[The clinical study of male infertility].

Male infertility study requires systematization of clinical and paraclinical diagnostic procedures and the knowledge of frontier techniques to analyze functional capacity of human spermatozoon. The application of the various methods of assisted reproduction in male infertility treatment, should be judged with a good criterion in order to offer maximal benefit and least risk. New methods to handle gametes and standardization of existing ones, could, in the future, offer better alternatives in male infertility treatment.

Humans↗
PubMed1991

[Renin activity in the plasma of premature newborns not ill].

In a prospective manner, sequential plasma renin activity (PRA) was measured in a group of sixteen non-sick premature infants on day 1, 3, 10, 17 and 24 of life. These infants had the following criteria in order to enter the study: breastfeeding, Apgar score greater than 7 at 5 minutes and no medical problems. PRA reached the maximum level by day 10,139 ng/mL/h declining slowly over the next two weeks, but remaining higher than on day one of life. Serum sodium levels were also measured since day one of life; these levels were found low during the entire time of study. We can speculate that our higher PRA values could be related to the physiologic hyponatremia found more accentuated between the third and fourth weeks of life.

Aging↗
PubMed1989

Fibrinogen Sevilla, a congenital dysfibrinogenemia characterized by an abnormal monomer aggregation and a defective plasmin lysis.

A dysfibrinogenemia (fibrinogen Sevilla) was detected in a 64-yr-old woman with no previous history of hemorrhagic diathesis or thrombosis. Thrombin and reptilase times were prolonged. The aggregation of fibrin monomers showed a prolonged latency time with a defective slope although fibrinopeptide release and clot stabilization were found to be normal. Plasmin proteolysis was abnormal with a much slower plasmic degradation in patient's purified fibrinogen. By chromatofocussing the patient's fibrinogen showed an abnormality in pattern elution with a second peak eluting at a pH slightly more basic than the normal one (pH 5.5). Likewise, the isoelectrofocussing of purified non-reduced patient's fibrinogen in agarose gel showed an abnormal distribution in its focussed bands, especially in a group which focussed in a pI-interval between 5.20-5.85. By two-dimensional electrophoresis we did not find any abnormality in the fibrinogen-reduced chains. These results could indicate that the abnormal monomer aggregation, as well as the defective plasmin lysis, could be due to conformational aspects of fibrinogen rather than to structural defects.

Blood Coagulation Disorders↗
PubMed1987

Bacterial growth in refrigerated human milk.

Unprocessed breast milk is currently being used as a desirable feeding alternative for premature infants. To assess some of the potential risks of this practice, we studied the bacterial growth in 41 samples of unprocessed human milk for a period of five days. No bacteria were cultured in eight samples of milk; the bacteria that were cultured in the remaining 33 samples were similar to those found on the skin and nipple of the breast. With the exception of three samples, two with Klebsiella and one with Pseudomonas, all identified bacteria have been reported as normal skin flora. The initial concentration of bacteria found in milk was low, with a mean of 10,000 colonies (range, 1000 to 140,000 colonies). Bacterial colony counts progressively decreased throughout the five-day refrigeration period.

Breast↗
PubMed1986

Effects of social support during parturition on maternal and infant morbidity.

Because continuous social support during labour is a component of care in many societies but inconsistent in our own, the clinical effect of support during labour on maternal and neonatal morbidity were studied. Social support was provided by female companions. Four hundred and sixty five healthy primigravidous women were enrolled using a randomised design. Compared with 249 women undergoing labour alone 168 women who had supportive female companions throughout labour had significantly fewer perinatal complications (p less than 0.001), including caesarean sections (7% v 17%, p less than 0.01) and oxytocin augmentation (2% v 13%, p less than 0.001), and fewer infants admitted to neonatal intensive care (p less than 0.10). Of the women who had an uncomplicated labour and delivery requiring no interventions, those with a companion had a significantly shorter duration of labour (7.7 hours v 15.5 hours, p less than 0.001). This study suggests that constant human support may be of great benefit to women during labour.

Clinical Trials as Topic↗