Spain's health care.
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Delivery of Health Care↗
Biomedical subjects
V Navarro
Publications and source records attributed to V Navarro.
Early postoperative occlusion of a left internal mammary artery bypass graft with subsequent restoration of patency.
Total occlusion of a left internal mammary artery (LIMA) bypass graft is a rare complication, and reversal of a documented occlusion has not been reported. This is a case of an early postoperative occlusion of a LIMA graft that was found to be patent 4 months later. A patient with three vessel disease (including a moderate lesion in the proximal left anterior descending artery and a severe lesion in its mid-portion) underwent coronary artery bypass grafting with a LIMA to the mid-left anterior descending artery (LAD) and saphenous vein grafts to the right coronary and left circumflex arteries. Coronary angiography 3 months after surgery revealed a totally occluded internal mammary artery and saphenous vein grafts. The patient then underwent a successful angioplasty of the more distal lesion in the LAD. She subsequently returned with recurrent angina. Repeat coronary angiography revealed rapid progression of the disease in the proximal LAD with the more distal angioplasty site being widely patent. Selective arteriography of the internal mammary artery at that time revealed a patent vessel. Thus, the internal mammary graft is a physiologically active conduit that is dependent on flow dynamics. Competitive flow through the nonobstructive native LAD in combination with impedance of flow through the internal mammary artery due to a severe lesion in the LAD distal to the anastomosis led to a functionally occluded LIMA. When the obstruction in the proximal LAD progressed and the distal obstruction was successfully angioplastied, the flow dynamics in the internal mammary improved, allowing for its dilatation and restoration of patency.(ABSTRACT TRUNCATED AT 250 WORDS)
Constriction, Pathologic↗
Detection of the Wolff-Parkinson-White syndrome after chest wall trauma.
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Adult↗
Solanum chrysotrichum (Schldl.) a plant used in Mexico for the treatment of skin mycosis.
An ethnobotanical field study carried out in 200 rural communities determined that the leaves of Solanum chrysotrichum Schldl. are used in Mexican traditional medicine for the treatment of skin mycosis, being particularly recommended to cure Tinae pedis. Clinical trials were performed using a cream containing 5% of a methanolic leaf extract of this plant. Results showed that 45% of the patients were completely cured after 4 weeks of topical treatment. The rest of the cases improved notably in comparison with the control group of patients using the habitual miconazole treatment. The same plant extract inhibited the growth in vitro of the dermatophytes Trychophyton mentagrophytes, T. rubrum and Microsporum gypseum at MICs under 15 mg/ml.
Antifungal Agents↗
Total pulmonary torsion without vascular compromise--a case report.
A new case of pulmonary torsion is reported. Only 15 cases of this rare entity have been published in the literature, all of them either surgically treated short term or resulting in death. Small right-side pneumothorax following diagnostic transthoracic puncture seemed to be the mechanism of production. Because of the absence of acute clinical manifestations, fibroscopy, isotopic perfusion scanning, and hemodynamic and pulmonary angiographic studies were done. The lack of compromise in the pulmonary flow and venous pulmonary return explains the surprisingly good progress (ten months, at present) of the patient.
Aged↗
Has socialism failed? An analysis of health indicators under socialism.
This article analyzes the widely held assumption in academia and the mainstream press that capitalism has proven superior to socialism in responding to human needs. The author surveys the health conditions of the world's populations, continent by continent, and shows that, contrary to dominant ideology, socialism and socialist forces have been, for the most part, better able to improve health conditions than have capitalism and capitalist forces. In the underdeveloped world, socialist forces and regimes have, more frequently than not, improved health and social indicators better than capitalist forces and regimes, and in the developed world, countries with strong socialist forces have been better able to improve health conditions than those countries lacking or with weak socialist forces. The socialist experience has, of course, also included negative developments that have negated important components of the socialist project. Still, the evidence presented in this article shows that the historical experience of socialism has not been one of failure. To the contrary: it has been, for the most part, more successful than capitalism in improving the health conditions of the world's populations.
Africa↗
Capitalism has not won.
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Developing Countries↗
[Herpes meningoencephalitis: diagnosis using polymerase chain reaction].
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Aged↗
[Candida laryngitis and HIV infection: description of 4 cases].
Candidiasic laryngitis is a very rare Candida spp infection of mucosa, appearing typically in immunosuppressed patients, mainly in patients with neoplasia, and, recently, in patients with Human Immunodeficiency Virus (VIH) infection. We present four cases of candidiasic laryngitis and HIV infection, as well as the clinical description and evolution of said cases after treatment with fluconazole. We review, as well, the cases published on the scientific literature. We maintain that in each HIV infected patient, with or without oral candidiasis, who shows dysphonia, candidiasic laryngitis should be ruled out.
Acquired Immunodeficiency Syndrome↗
[Fluconazole treatment of cryptococcal meningitis associated with HIV infection. Presentation of 4 cases].
We present four cases of C. neoformans meningitis (CNM) in patients with Human Immunodeficiency Virus (HIV) infection treated with fluconazole p.o. at an initial dose of 400 mg followed by 200 mg/day during a follow up period ranging from 3 to 12 months, and who presented an excellent clinical evolution. When comparing them to our previous cases who were treated with Amphotericin-B in combination with 5-fluorocytosine, a decrease in mean hospital stay (p less than 0.001) and a smaller incidence of secondary effects were observed. Treatment with fluconazole seems to be an effective alternative in treatment of CNM. Future greater studies are needed to confirm this findings.
Administration, Oral↗
[Pneumocystis carinii pneumonia in AIDS and prolonged fever].
Pneumonia by Pneumocystis carinii (NPC) presents a high incidence in the evolution of patients infected by the human immunodeficiency virus (HIV). Common clinical signs include fever, dry cough and dyspnea, in the presence of pulmonar interstitial affection with several degrees of hypoxemia. One hundred and sixteen patients with NPC and infection by HIV were diagnosed between December 1986 and January 1990. Criteria of persistent fever was established in 10 of them (8.7%), with normal thoracic radiography at the time of hospitalization. NPC in the adquired immunodeficiency syndrome (SIDA) may develop' with persistent fever, joining the large relation of entities manifesting in this way.
Acquired Immunodeficiency Syndrome↗
[A serum immunoglobulin study in patients with tuberculosis and human immunodeficiency virus infection].
We present the immunoglobulin spectrum in a series of 156 HIV-infected patients who were affected of tuberculosis (TB) of different localization. Sixty-seven patients had lung TB, in 13 cases lung TB and an opportunistic infection were diagnosed simultaneously and in 76 cases TB was localized outside the lung. The cases were compared to 62 HIV-infected patients classified in stage 11 (CDC 1986) and to 85 cases of HIV-infected patients who suffered carinii pneumonia (PCP). The most outstanding differences were established between IgA of patients with lung TB and group PCP (p less than 0.001). IgG showed significant differences between lung TB patients and the PCP group (p less than 0.001).
Acquired Immunodeficiency Syndrome↗
Running energetics in the pronghorn antelope.
The pronghorn antelope (Antilocapra americana) has an alleged top speed of 100 km h-1, second only to the cheetah (Acionyx jubatus) among land vertebrates, a possible response to predation in the exposed habitat of the North American prairie. Unlike cheetahs, however, pronghorn antelope are distance runners rather than sprinters, and can run 11 km in 10 min, an average speed of 65 km h-1. We measured maximum oxygen uptake in pronghorn antelope to distinguish between two potential explanations for this ability: either they have evolved a uniquely high muscular efficiency (low cost of transport) or they can supply oxygen to the muscles at unusually high levels. Because the cost of transport (energy per unit distance covered per unit body mass) varies as a predictable function of body mass among terrestrial vertebrates, we can calculate the predicted cost to maintain speeds of 65 and 100 km h-1 in an average 32-kg animal. The resulting range of predicted values, 3.2-5.1 ml O2 kg-1 s-1, far surpasses the predicted maximum aerobic capacity of a 32-kg mammal (1.5 ml O2 kg-1 s-1). We conclude that their performance is achieved by an extraordinary capacity to consume and process enough oxygen to support a predicted running speed greater than 20 ms-1 (70 km h-1), attained without unique respiratory-system structures.
Animals↗
[Weil's disease with pulmonary, visceral and cutaneous manifestations].
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Adult↗
Race or class or race and class: growing mortality differentials in the United States.
Recent statistics on increasing differences in mortality rates between blacks and whites in the United States are causing a great deal of concern. The reduction of this gap is an important national goal. Yet mortality differentials cannot be explained solely by race. We must also look at class, as do all Western nations other than the United States, when compiling health statistics. In the United States, how people live, get sick, and die depends not only on their race, sex, and age, but also on their class, whether measured by level of education, income, or occupation. Class differentials in mortality and morbidity are greater than race differentials. By focusing our attention on race differentials alone, we will not be able to understand why the health indicators of minorities in the United States are deteriorating.
Black or African American↗
An analysis of the American Medical Association's recommendations for change in the medical care sector of the United States.
In several recent publications, the American Medical Association has provided explanations of the current crisis in the medical sector of the United States. This article presents empirical information that questions the basic assumptions behind the AMA's explanations of the U.S. realities and the AMA's recommendations on how to solve the current crisis. The author also critically reviews some of the major proposals--such as employer mandated coverage--that are being put forward by several forces in the United States, including the AMA, for resolving the twin problems of high costs and limited health benefits coverage for the U.S. population. The political context in which the AMA's calls for reforms are being made is also discussed.
American Medical Association↗
Production and the welfare state: the political context of reforms.
This article is an analysis of the political context of reforms in the production process and in the welfare state. The theories of legitimation and Fordism are criticized for considering the capitalist class the main force behind the reforms. The working class and the process of class struggle are primarily responsible for changes in production and for the establishment of the welfare state. The author then shows that the changes in production and in the state that occurred after World War II were a response to political events triggered by labor's rebellions and capital's need to respond to those rebellions. Post-Fordism and the political practice that derives from it are criticized for their hasty dismissal of class and class practices by the dominated forces in society. The article ends by offering an alternative strategy for change.
Europe↗
The relevance of the U.S. experience to the reforms in the British National Health Service: the case of General Practitioner Fund Holding.
This article presents a discussion of the relevance of the U.S. experience in general, and health maintenance organizations in particular, to the reforms advocated by the current Conservative government in the general practitioner services of the British National Health Service. The author analyzes empirical information relevant to the assumptions made by the Conservative reformers that (1) the HMO type of practice is better able to respond to people's needs than are current general practitioner arrangements; (2) entrepreneurship in medicine is good for patients; (3) market-based primary care is more efficient than the nonmarket system in the United Kingdom; and (4) the expansion and strengthening of the private sector is an efficient and equitable means of encouraging competition and raising revenues. All of these assumptions are questioned.
Economic Competition↗