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Biomedical subjects

V García

Publications and source records attributed to V García.

At least 55 records · Page 3Linked to original sources
PubMed1992

[The accidents and complications of laparoscopy. A review of 8,915 cases].

Complications occurring in 8,915 laparoscopies done during 1957-1991 are analyzed. Complications were classified as major or minor, according to the need of surgical intervention for their management, and also in relation to pneumoperitoneum, introduction of the laparoscope, during the examination or after laparoscopy. The total number of major accidents was 54 (0.60%). Half of them as a consequence of the instrumentation or of liver biopsy. There were 442 minor complications (4.96%). Mortality included 10 patients (0.11%) as a sequel of uncontrolled haemorrhage, 5 of them after liver biopsy. The complications of laparoscopy cannot be ignored; as all invasive techniques it may have a risk, even in the most expert hands. Half of the major accidents and of the mortality were due to complications from liver biopsy.

Accidents↗
PubMed1991

[Antimicrobial activity of ornidazole and 6 other antibiotics against anaerobic bacteria].

The antimicrobial susceptibility of 235 anaerobic bacterial strains to ornidazole, metronidazole, chloramphenicol, clindamycin, penicillin, cefoxitin and imipenem has been studied using agar-dilution technique. Ornidazole and metronidazole were active against 88.6% and 86% of gram-positive cocci. Overall, 99.1% of Bacteroides group fragilis, and 91.3% of non-fragilis Bacteroides were also sensitive to both drugs. We did not find any Clostridium perfringens resistant strain. Cefoxitin and penicillin showed good activity against all Clostridium perfringens strains, and also against 97.7% and 92.5% of gram-positive cocci. We found one single imipenem resistant strain among gram-positive bacteria. Bacteroides fragilis also showed sensitivity to penicillin (41.5%), cefoxitin (85.7%) and imipenem (97.1%). Clindamycin was active against Clostridium perfringens (90.9%), gram-positive cocci (86.7%) and imipenem (68.6%). Chloramphenicol showed good activity against Clostridium perfringens (100%), gram-positive cocci (95.5%) and Bacteroides spp. (99.4%). Our results showed an overall good activity of all the seven drugs tested against anaerobic gram-positive microorganisms. Of notice, we found a good activity of chloramphenicol, imipenem, metronidazole and ornidazole against Bacteroides spp.

Anti-Bacterial Agents↗
PubMed1989

The quality control of tuberculin PPD products from seven Latin American laboratories.

The Pan American Health Organization, through its Pan American Zoonoses Center (CEPANZO), distributes the concentrated stock solution of PPD batch RT23 (1 mg ml-1 = 50,000 TU ml-1) to national central laboratories. In the laboratories the stock solution is diluted to 2 TU/0.1 ml and dispensed with the addition of Tween 80 and either chinosol or phenol as preservatives in rubber-stoppered vials for use in the Mantoux test. The expiry date is usually fixed at six months after filling. Samples of nine lots of PPD 2 TU from seven countries (Argentina, Brazil, Colombia, Dominican Republic, Ecuador, Paraguay and Uruguay) were received by CEPANZO for quality control. The biological activity and phenol concentrations of these samples were assayed periodically after storage at 4, 25 or 37 degrees C either unopened or opened and re-used in a manner simulating extreme field conditions of use and storage. The object of the study was to determine the stability of the biological activity as well as the maintenance of sterility of these conditions with a view to assessing the need for stricter requirements for the labelling of tuberculin. The results obtained showed that PPD 2 TU with 0.4-0.5% (w/v) phenol added, and dispensed in vials, was stable in its biological activity and maintained its sterility. Therefore, it seems unnecessary to issue stricter requirements than those currently applied.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMedDate not supplied

[The main problems of occupational health in Navarra, 1994-1996].

In 1996 the Navarra Occupational Health Institute, an autonomous technical organization that integrates the functions and means related to occupational health matters, drew up the Occupational Health Diagnosis of Navarra, which is a region characterised by its important industrial sector and its high proportion of small and medium size companies. The results emphasise the high accident rate in the construction sector, the constant increase of professional diseases through "fatigue of tendon pods", as well as the importance of osteo-muscular processes as a cause of temporary and permanent disability. Forty sentinel occupational tumors, mainly mesothelioma, and 27 Obligatory Statement Diseases of occupational origin, mainly brucellosis, were identified in a period of seven years and three years, respectively. Verification was made of a lack of systematised information about population exposure to occupational risks, a scarce development of medical surveillance of exposed workers, and a lack of information about the incidence of occupational injuries in self-employed workers.

English Abstract↗
PubMedDate not supplied

[Myocardial Infarction in the population aged 25-74 in Navarra. Incidence, lethality and treatment in the period 1997-98. IBERICA study].

The principal aim of this study was to determine the incidence of Myocardial Infarction in the population aged 25-74 in Navarra, lethality after 28 days, and the characteristics of the treatment applied in the hospitals during the years 1997-1998. A search was conducted for possible cases of heart attack in the hospital services responsible for attending to them, by means of a review of clinical histories. The lethal cases that did not reach the hospitals were researched through the statistical bulletins of deaths, with the information on these deaths completed through the family doctors. 1,059 coronary events were registered, which corresponded to a crude rate of attack of 238 cases per 100,000 amongst men and 59 cases per 100,000 amongst women. Amongst the male patients who reached hospital alive, 50% were smokers, 41% showed hypercholesterolaemia, 35.9% were hypertense and 16% were diabetic. Amongst the women, who showed a higher average age, arterial hypertension was the most frequent risk factor, with 66%. During hospitalisation thrombolysis was carried out on 39.2% of the patients, primary or rescue angioplasty on 4.6%; aspirin or other anticoagulants were administered to 94.2%, beta-blockers to 60.6% and IECA to 37.4%. This study has shown that the frequency of Myocardial Infarction in Navarra is lower than that registered in many European and North American countries, and is concordant with the low rates of mortality due to this cause. Global analysis of the data shows that a high implementation of the care guidelines for this disease with respect to the use of efficient therapies could be observed in the years 1997 and 1998. Nonetheless, with the exception of the use of anticoagulants, hospital variability has been observed in the use of thrombolytic therapy and adjuvant therapies such as the beta-blockers or ACE Inhibitor, and in the use of diagnostic techniques such as arteriography.

English Abstract↗
PubMedDate not supplied

[Fungemia by Candida non albicans in patients with HIV infection].

OBJECTIVE: To analyse candidemia by Candida non albicans in adult HIV-infected patients from 1989 to August 1998. PATIENTS AND METHODS: We retrospectively reviewed all HIV patients who presented at least one positive peripheral blood culture for Candida spp. Clinical, epidemiologic, immunologic and evolutive characteristics, and risk factors for candidemia were analysed. RESULTS: During this period of time, 2,025 HIV-infected patients were diagnosed. Five of them developed candidemia by C. albicans and 6 by C. non albicans. These last ones were all men with mean age of 32.1 years old, and intravenous drug use was the risk factor for HIV in 5 of them; aids had previously been diagnosed in 4 patients and 3 had receipt imidazoles. None was neutropenic. Three cases were nosocomially acquired. Median CD4 cell count was 108.6 x 10(6)/l (3-366). Candida krusei was isolated in two intravenous drug users, Candida parapsilosis in two other patients and Candida glabrata and Candida tropicalis in one of the other two cases each. We treated 2 patients with amphotericin B and 2 with fluconazole. One patient died. CONCLUSIONS: Candidemia is not frequent in HIV-infected patients. Candidemia by C. non albicans in HIV-infected patients presents similar characteristics as in other immunodepressed patients and it is fundamentally associated with previous use of imidazoles, nosocomial acquisition and late-stage aids. It is noteworthy that C. krusei was isolated in two intravenous drug users.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

[The effect of discontinuation of methylphenidate at adolescence onset on adult attention deficit hyperactivity disorder].

INTRODUCTION: The positive effect of methylphenidate on children and adults with ADHD is well known. However, the effect of discontinuation of methylphenidate at adolescence onset on adult s ADHD is unknown. Objective. To determine the effect of discontinuation of methylphenidate at adolescence onset on adult s attention deficit, hyperactivity, impulsivity and functional disabilities. PATIENTS AND METHODS: Adults and their parents, spouses and/or friends were requested to fill out the same criteria diagnosis form filled out by their parents and teachers before (7 years of age), during (7.5 years of age) and at the end of treatment (12 years of age). They took methylphenidate (0.1 0.5 mg/kg/day) from age 7 to 12 years because ADHD. Inattention, hyperactivity, impulsivity and functional disability were statistically analyzed by the paired sample method before, during at the end of treatment and at age 27 years. RESULTS: Methylphenidate used for 5 years (7.5 12 years of age) improved significantly (p< 0.001) the average score for inattention, hyperactivity, impulsivity and functional impairment compared to pre (7 year of age) and post (27 years of age) treatment. The discontinuation of methylphenidate for 15 years (12 27 year of age) deteriorate significantly the average score for inattention and functional impairment when pre adolescent and adult values were compared (p< 0.001). CONCLUSIONS: The results strongly suggest that methylphenidate must be used throughout the adulthood to avoid the degree of inattention and functional disability found in this study.

Adolescent↗
PubMedDate not supplied

[Effect of sevoflurane on the neuromuscular blockade produced by continuous mivacurium infusion ].

OBJECTIVE: To evaluate the effect of sevoflurane on a neuromuscular block from mivacurium in continuous infusion. PATIENTS AND METHODS: Fourteen ASA I-II patients receiving general anesthesia for orthopedic procedures on the knee. The neuromuscular block was monitored by acceleromyography in the adductor pollicis muscle after stimulation of the cubital nerve. Anaesthesia was induced with propofol and remifentanil. After orotracheal intubation, mivacurium was given in continuous infusion adjusted to obtain a stable submaximal block defined as a variation in the block of 3% more or less for 10 minutes (first response on a train of four [T1] between 40% and 60% of the calibrated value). Values for T1, the T4/T1 ratio (TR) and temperature over the thenar eminence were recorded at 3 moments: control moment (infusion of mivacurium and sevoflurane at an expired fraction of 1.5% for 30 minutes) and post-sevoflurane moment (perfusion of mivacurium and sevoflurane at an expired fraction of 0% for 15 minutes). Statistical analysis was by analysis of variance and post-hoc contrast (Tukey). RESULTS: Results are expressed as means with standard error between parentheses. We found that values at T1(%) and TR(%) were significantly lower at the sevoflurane moments (T1 = 43.11 [1]; TR = 25.68 [1]) and the post-sevoflurane moment (T1 = 36.29 [2]; TR = 25.06 [2]) than at the control moment (T1 = 53.18 [1]; TR = 38.93 [1]) (P < .05). T1 was significantly lower at the post-sevoflurane moment than at the sevoflurane moment (P < .05) but TR did not differ significantly. CONCLUSION: Sevoflurane causes a significant increase in the neuromuscular block maintained by mivacurium in continuous infusion and the increase lasts at least 15 minutes after the halogenated agent is cleared from blood.

Adult↗
PubMedDate not supplied

[Performance analysis of a new anesthetic system: the Temel Supra--part I].

OBJECTIVES: To evaluate the performance of a new anesthetic system that purports to provide novel advantages in ventilating the anesthetized patient. MATERIAL AND METHODS: A performance analysis was carried out in our respirator function laboratory using lung simulators to assess the system, its degree of compliance with current regulations, and the degree of compliance with the manufacturer's claims. RESULTS: The system is 100% effective. The internal compliance of the respirator was 0.13 +/- 0.01 mL/cm H2O, inspiratory resistance was 1.9 +/- 0.1 cm H2O/L/s, expiratory resistance was 3.1 +/- 0.3 cm H2O/L/s, and internal volume was 130 mL. CONCLUSIONS: The Temel Supra device is versatile and meets the anesthetic requirements of patients undergoing any type of surgery. The possibility of using an open circuit, a low flow, a closed circuit, or a continuous flow without having to change to another system allows the anesthesiologist to make use of the advantages of each circuit without its drawbacks. The efficacy of the circuit is 100%. The low internal volume means that internal compliance is negligible and time constants are low, guaranteeing that the volume programmed is the same as the volume delivered and facilitating alveolar redistribution of gases. The monitoring and warning systems assure safe patient ventilation and accurate dosing of gases and anesthetic agents.

Anesthesiology↗
PubMedDate not supplied

[Acute lung injury related to transfusion of fresh frozen plasma].

A 23-year-old woman with no relevant medical history required transfusion of 2 units of fresh frozen plasma before diagnostic laparoscopy. Following transfusion, serious bilateral pulmonary edema with hypoxia developed and resolved with 48 hours of mechanical ventilation. Immunological testing of blood from the 2 donors and the patient revealed the presence of anti-HLA DR-52 antibodies in the plasma of a donor and the presence of the corresponding antigen in the patient, confirming the diagnosis of fresh frozen plasma transfusion-related acute lung injury. Transfusion-related acute lung injury associated with plasma-containing blood products has an incidence of 1:5000 transfused units and a mortality rate of up to 10% of cases. Clinical suspicion should remain high in making the diagnosis and ruling out other causes of pulmonary edema, given that a firm diagnosis will come only after immunological testing. Transfusion-related acute lung injury is considered an under-diagnosed syndrome and must be included in the differential diagnosis of respiratory distress when a transfusion has been given.

Adult↗