Biomedical subjects
Publications and source records attributed to T Rodríguez.
The authors present here a case report of colloid milium beginning early in the childhood , with affectation of four relatives in the same generation, suggesting a pattern of inheritance in a recessive way.
A morphologic (phase-contrast, TEM and SEM) and cytochemical study was performed on L929 cell variants that show different malignant behavior and lung colonization ability in C3HA/Hab mice. The paper presents and discusses the correlation between enhanced lung colonization ability and the expression in culture of rounded, risen, less attached morphologies. Also, a diminution in the activity of mitochondrial enzymes and number of these cell organelles was found for the cell variant selected for enhanced lung colonization ability.
Sixteen cases of polymyositis were submitted to study. Out of these sixteen, nine showed no clinical or paraclinical evidences of cancer, and seven presented an associated cancer. In the first group, a normal immune response was observed, whereas in the second group this response was frankly depressed. Emphasis is laid on the significance of the immune response, not only in the diagnosis but as a fundamental factor in prognosis and treatment as well. An early treatment of polymyositis without cancer proved to be satisfactory. On the other hand, when a neoplasm was present, the course of the disease was satisfactorily modified only after the extirpation of the neoplasm.
INTRODUCTION: Patient satisfaction is a good performance indicator for measuring the quality of health care delivered by hospitals. Satisfaction is understood to be the positive difference between users' perceptions of their experience at the moment of discharge and their expectations at the moment of admission. OBJECTIVE: To evaluate the expectations and the perceived quality of care in cataract surgery patients attending Hospital Clinic (HC). METHOD: A two-stage descriptive study carried out at the HC in Barcelona, Spain. The target population consisted of patients operated on for cataracts during the 1996 calendar year. Two study groups were established: Group I, patients attending outpatient service before admission; and Group II, patients attending outpatient service after surgery. After informed consent was obtained, the patients were directly interviewed by three researchers especially trained for that purpose. The questionnaire included demographic variables and 31 questions related to expectations, all to be answered by means of a 7 points Likert's visual scale. All statistical calculations were performed using the SPSS program for Microsoft Windows. RESULTS: A total of 148 interviews were performed: 80 (54.1%) in Group I and 68 (45.9%) in Group II. The mean age was 64.2 +/- 11.6 years. The difference between scores at admission and at discharge was nearly significant (p = 0.064) for the "information" component. CONCLUSIONS: The study of several fields where the patient's expectations are higher or lower contributes to prioritizing efforts to improve quality. There is a need for a frequent review and update of any patient satisfaction evaluation tools that are used.
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Decisions have to be made about what data on patient characteristics and processes and outcome need to be collected, and standard definitions of these data items need to be developed to identify data quality concerns as promptly as possible and to establish ways to improve data quality. The usefulness of any clinical database depends strongly on the quality of the collected data. If the data quality is poor, the results of studies using the database might be biased and unreliable. Furthermore, if the quality of the database has not been verified, the results might be given little credence, especially if they are unwelcome or unexpected. To assure the quality of clinical database is essential the clear definition of the uses to which the database is going to be put; the database should to be developed that is comprehensive in terms of its usefulness but limited in its size.
INTRODUCTION: L-2-hydroxyglutaric aciduria is a rare inborn error of metabolism, autosomal recessive, identified in about 50 patients. The primary defect is still unknown. The clinical phenotype is variable. Affected individuals show slowly progressive neurodegenerative disorder with cerebellar ataxia and mental retardation. Pyramidal, and extrapyramidal signs, seizures and macrocephaly have been reported. All patients previously described show a pattern of subcortical leukoencephalopathy with nearly empty gyral cores and cerebellar atrophy in neuroimaging studies. The diagnosis is established by detection of increased levels of L-2-hydroxyglutaric acid in urine, plasma and cerebrospinal fluid. CASE REPORTS: We here describe two patients 7 and 9 years old, who presented psychomotor retardation, seizures, progressive cognitive deterioration, and pyramidal, extrapyramidal and cerebellar signs. Magnetic resonance scanning of the brain demonstrated a bilateral subcortical leukoencephalopathy pattern and areas of increased T2-weighted signal in the basal ganglia and cerebellar dentate nuclei. The analysis of organic acids in urine by gas chromatography/mass spectrometry showed elevated 2-hydroxyglutaric acid, 100% of it in the form of L enantiomer. CONCLUSION: The diagnostic consideration is based on clinical findings and typical neuroimaging pattern and is established by detection of L-2-hydroxyglutaric acid in body fluids. Subcortical white matter loss is an important clue to diagnosis.
AIMS: To analyze the real possibility to use ready-to-use multichamber bags for total parenteral nutrition in adult patients on home parenteral nutrition. METHODS: In June 2005 we studied the adult patients on home parenteral nutrition treatment controlled by the Nutritional Support Unit from an University Hospital. Demographic data, data relating to underlying disease state; infusion regimen and the necessity to modify it; body mass index, fat free mass index, and Karnofsky index evolution, and complications related to parenteral nutrition were assessed. RESULTS: At the time of the study, 8 patients aged 48,9 +/- 17,7 years, were on home parenteral nutrition. The artificial nutrition treatment was administered due to short-bowel syndrome (2); motility disorders (2); suboclusion (2); rapid intestinal transit (1), and malabsorption syndrome (1). With the exception of the patient who started more recently the treatment, all the others needed changes in the parenteral nutrition treatment (number of days for week, or formula modification). In general, both the body mass index and the fat free mass index increased during the treatment. The Karnofsky index was maintained or increased. In relation to catheter-related infection, 4 episodes were observed (0.85/1.000 d of HPN). CONCLUSIONS: Due to the effectiveness, safety and the diversity of multichamber bags available for parenteral nutrition, and the few complications observed in the patients studied, although more studied are necessary, our results suggest that we can use this commercial bags for adult patients on home parenteral nutrition.
Left ventricular systolic stress was studied in nineteen patients with mitral stenosis, twelve in sinus rhythm and seven in atrial fibrillation. Left ventricular dimensions and volumes and septal and posterior wall thickness were measured by means of M and two bidimensional echocardiography at rest and during isometric exercise. Expulsive indices: fractional shortening, ejection fraction and mean circumferential shortening rate were calculated. Ventricular mass, meridional stress and several end-systolic stress or pressure/volume relationships were estimated. Patients with atrial fibrillation were older and had systolic dysfunction: greater end-systolic volumes and depression of both expulsive fractions and some of the end-systolic indices. Preload and wall thickness were normal. Patients with atrial fibrillation showed higher ventricular stress as a consequence of greater ventricular dimensions. Ejection fraction correlates directly with mitral valve area and inversely with inotropic state and heart rate. It is concluded that systolic dysfunction in mitral stenosis is multifactorial. The most important determinants of the abnormality are heart rate and inotropic state. The study did not show any primary abnormality of afterload or hypotrophy of the left ventricle.
A common clinical problem is the differentiation among ejection and regurgitant murmurs. Inhalation of amyl nitrite is useful for this purpose because it increases the intensity of ejection murmurs while decreases that of regurgitant ones. Because amyl nitrite is not easily available, inhaled isoproterenol was tested in seventeen patients with ejection murmurs and eighteen with regurgitant ones. Isoproterenol was administered at doses of 480-640 mcg, according to age and corpulence. The changes in murmur amplitude and heart rate were phonocardiographically registered immediately and then every 15'' up to a minute and a half after the inhalation, and were expressed as percent of change with respect to basal values. Heart rate increased in both groups. The intensity of ejection murmurs increased immediately and maximally 45'' after inhalation; on the contrary, the intensity of regurgitant murmurs decreased immediately and maximally 15'' after inhalation. It is concluded that isoproterenol, whose effects are similar to those of amyl nitrite, can substitute the latter in the clinical and phonocardiographically differentiation of systolic murmurs.
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Peritoneal macrophages in rats with no immunization against rubella virus and inoculted with bovine infectious rhinotracheitis virus are prone to suffer from a cytopathogenic effect with formation of inclusion bodies, and lysis, succeeding in reisolating the virus. The resistance of peritoneal macrophages of rats inoculated against rubella virus in nonspecific, since such resistance continues to show when macrophages interact with bovine infectious rhinotracheitis virus. The results support evidence that in the Inflammatory process suffered by rubella virus-inoculated rats, a cell immunity develops and macrophages are some of the cells performing the response.
The pathogenicity of rubella virus for macrophages of immune and non-immune rats was studied using not a natural route of inoculation and studying the sequence of morphologic changes in cells as well as virus growth in the peritoneal cavity, the development of viremia and the neutralizing antibody response against the infectious agent. Non-immune rats evidenced a possible development of cell immunity in the course of the process. Immune rats had acquired a cell immunity in addition to a specific secondary response manifested early at the beginning of infection.
In vitro peritoneal macrophage cultures of rats with no immunization against rubella virus and inoculated with these viral agents are prone to permit its intracellular proliferation and suffer a cytopathogenic effect and lysis. Peritoneal macrophages of immune rats do not permit intracellular proliferation and prevent harmful viral action. In the in vivo studies, peritoneal macrophages of non-immune rats eventually show a resistance to rubella virus during the infection. Our results suggest that macrophages require the co-operation of other elements involved in the living animal immunity in order to show resistance to rubella virus.