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Trastoy R, Manso T, García X, Barbeito G, Navarro D, Rascado P, Pérez Del Molino ML. [Pulmonary co-infection due to Nocardia cyriacigeorgica and Aspergillus fumigatus]. Rev Esp Quimioter 2017; 30:123-126. [PMID: 28176520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Pulmonary nocardiosis is an uncommon pulmonary infection caused by aerobic gram-positive bacteria of the genus Nocardia. Nocardia sp. are environmental organisms spread worldwide. Approximately 50 Nocardia species have been described to date, about 30 of which are known to cause human disease. Nocardia cyriacigeorgica was first reported in 2001. CASE REPORT We report a case of infection caused by N. cyriacigeorgica in a patient with B-cells non-Hodgkin lymphoma and diabetes mellitus. The microbiological findings reflect a possible co-infection by N. cyriacigeorgica and Aspergillus fumigatus. CONCLUSIONS Patient's background and information related to risk factors are essential to detect the growth of Nocardia sp. in the laboratory. Furthermore, diagnosis of invasive pulmonary aspergillosis is particularly controversial, especially in intensive care units patients. Taking everything into account, we will discuss a possible co-infection by N. cyriacigeorgica and A. fumigatus in a critically ill patient.
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Affiliation(s)
- R Trastoy
- Rocío Trastoy, Servicio de Microbiología y Parasitología. Complejo Hospitalario Universitario de Santiago de Compostela. Travesía de Choupana, s/n, 15706 Santiago de Compostela, A Coruña, Spain.
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González P, García X, Guerra A, Arango J, Delgado H, Uribe C, Sará J, López de Mesa J, Hernández O. Experience with Guillain-Barré syndrome in a neurological Intensive Care Unit. Neurología (English Edition) 2016. [DOI: 10.1016/j.nrleng.2014.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Cortejoso L, García MI, García X, González-Haba E, Sanjurjo M, López-Fernández L. PS-020 The cost-effectiveness of screening for dihydropyrimidine dehydrogenase polymorphisms in cancer patients treated with fluoropyrimidines. Eur J Hosp Pharm 2015. [DOI: 10.1136/ejhpharm-2015-000639.346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Paleo AJ, García X, Arboleda-Clemente L, Van Hattum FW, Abad MJ, Ares A. Enhanced thermal conductivity of rheologically percolated carbon nanofiber reinforced polypropylene composites. POLYM ADVAN TECHNOL 2015. [DOI: 10.1002/pat.3462] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- A. J. Paleo
- Grupo de Polímeros. Departamento de Física; Universidade de A Coruña, Laboratorio de Polímeros. E.U.P.; Avda 19 Febrero, s/n 15405 Ferrol Spain
| | - X. García
- Grupo de Polímeros. Departamento de Física; Universidade de A Coruña, Laboratorio de Polímeros. E.U.P.; Avda 19 Febrero, s/n 15405 Ferrol Spain
| | - L. Arboleda-Clemente
- Grupo de Polímeros. Departamento de Física; Universidade de A Coruña, Laboratorio de Polímeros. E.U.P.; Avda 19 Febrero, s/n 15405 Ferrol Spain
| | - F. W. Van Hattum
- Saxion University of Applied Sciences; Research Center Design and Technology; M.H. Tromplaan 28, Postbus 70.000 7500 KB Enschede Netherlands
| | - M. J. Abad
- Grupo de Polímeros. Departamento de Física; Universidade de A Coruña, Laboratorio de Polímeros. E.U.P.; Avda 19 Febrero, s/n 15405 Ferrol Spain
| | - A. Ares
- Grupo de Polímeros. Departamento de Física; Universidade de A Coruña, Laboratorio de Polímeros. E.U.P.; Avda 19 Febrero, s/n 15405 Ferrol Spain
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González P, García X, Guerra A, Arango JC, Delgado H, Uribe CS, Sará J, López de Mesa JC, Hernández O. Experience with Guillain-Barré syndrome in a neurological Intensive Care Unit. Neurologia 2014; 31:389-94. [PMID: 25542501 DOI: 10.1016/j.nrl.2014.09.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Revised: 05/05/2014] [Accepted: 09/06/2014] [Indexed: 10/24/2022] Open
Abstract
INTRODUCTION Guillain-Barré syndrome, an acute polyradiculoneuropathy that presents with weakness and areflexia, is the most common cause of acute flaccid paralysis. In certain patients, respiratory failure is secondary to this disorder, eventually causing patients to require mechanical ventilation and experience additional complications due to diminished respiratory support and related mobility limitations. Prognoses for most of these cases are positive; treatment consists of basic support combined with plasmapheresis or administration of immunoglobulins. OBJECTIVE This study sought to describe the socio-demographic, clinical, laboratory and neurophysiological characteristics of patients with Guillain-Barré syndrome who were hospitalised in the Intensive Care Unit of the Neurological Institute of Colombia between 2006 and 2012. METHODOLOGY This study presents a case series. RESULTS We surveyed 25 patients (32% female and 68% male) with Guillain-Barré syndrome and an average age of 54 years. Sixty per cent of these patients were admitted between days 3 and 7 after symptom onset; 64% had a history of respiratory infection and 20% had a history of intestinal infection. In addition, 84% of the patients presented with albuminocytological dissociation. We observed the following clinical subtypes of Guillain-Barré syndrome: inflammatory demyelinating polyneuropathy in 32%, acute motor-sensory axonal neuropathy in 28%, acute motor axonal neuropathy in 28%, and Miller Fisher syndrome in 12%. CONCLUSIONS In this descriptive study of a group of critical care patients with GBS, results depended on patients' clinical severity at time of admission. Our findings are similar to results published in the international literature.
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Affiliation(s)
- P González
- Servicio de Neurología, Universidad de Antioquia, Medellín, Antioquia, Colombia.
| | - X García
- Neuróloga, Universidad Nacional de Bogotá
| | - A Guerra
- Servicio de Neurología, Universidad de Antioquia, Medellín, Antioquia, Colombia; Neuróloga, Universidad Nacional de Bogotá; Profesor de Neurología, Universidad de Antioquia, Neurólogo UCI INDEC; Intensivistas, Unidad de Cuidados Intensivos, INDEC, Medellín, Antioquia, Colombia
| | - J C Arango
- Servicio de Neurología, Universidad de Antioquia, Medellín, Antioquia, Colombia; Neuróloga, Universidad Nacional de Bogotá; Profesor de Neurología, Universidad de Antioquia, Neurólogo UCI INDEC; Intensivistas, Unidad de Cuidados Intensivos, INDEC, Medellín, Antioquia, Colombia
| | - H Delgado
- Servicio de Neurología, Universidad de Antioquia, Medellín, Antioquia, Colombia; Neuróloga, Universidad Nacional de Bogotá; Profesor de Neurología, Universidad de Antioquia, Neurólogo UCI INDEC; Intensivistas, Unidad de Cuidados Intensivos, INDEC, Medellín, Antioquia, Colombia
| | - C S Uribe
- Profesor de Neurología, Universidad de Antioquia, Neurólogo UCI INDEC
| | - J Sará
- Servicio de Neurología, Universidad de Antioquia, Medellín, Antioquia, Colombia; Neuróloga, Universidad Nacional de Bogotá; Profesor de Neurología, Universidad de Antioquia, Neurólogo UCI INDEC; Intensivistas, Unidad de Cuidados Intensivos, INDEC, Medellín, Antioquia, Colombia
| | - J C López de Mesa
- Servicio de Neurología, Universidad de Antioquia, Medellín, Antioquia, Colombia; Neuróloga, Universidad Nacional de Bogotá; Profesor de Neurología, Universidad de Antioquia, Neurólogo UCI INDEC; Intensivistas, Unidad de Cuidados Intensivos, INDEC, Medellín, Antioquia, Colombia
| | - O Hernández
- Intensivistas, Unidad de Cuidados Intensivos, INDEC, Medellín, Antioquia, Colombia
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Treviño M, García-Riestra C, Areses P, García X, Navarro D, Suárez FJ, López-Dequidt IA, Zaragoza O, Cuenca-Estrella M. Emerging Trichosporon asahii in elderly patients: epidemiological and molecular analysis by the DiversiLab system. Eur J Clin Microbiol Infect Dis 2014; 33:1497-503. [PMID: 24718613 DOI: 10.1007/s10096-014-2099-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Accepted: 03/20/2014] [Indexed: 11/29/2022]
Abstract
Trichosporon asahii has been recognized as an emerging opportunistic agent for invasive infections, mainly in immunocompromised patients. Urinary tract infections by this pathogen may also occur, especially in patients with urinary obstruction or those undergoing vesical catheterization and antibiotic treatment. Many outbreaks of Trichosporon spp. have been detected after urinary catheter manipulations. We report the molecular-epidemiological characterization of T. asahii in our institution using the DiversiLab system for the molecular strain typing and compare three different methods for susceptibility testing. Our results present T. asahii as an emergent pathogen in elderly patients with urinary drainage devices that can be adequately treated with triazoles, with voriconazole being the most active. Broth dilution and Vitek 2 had good concordance, while Etest showed more discrepancies. In addition, the DiversiLab system for clonal strain typing may be a useful tool for fast and accurate management of nosocomial outbreaks.
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Affiliation(s)
- M Treviño
- Servicio de Microbiología, Complejo Hospitalario Universitario de Santiago de Compostela, c/ Travesía Choupana s/n, 15706, Santiago de Compostela, Spain,
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Ochagavía A, Baigorri F, Mesquida J, Ayuela JM, Ferrándiz A, García X, Monge MI, Mateu L, Sabatier C, Clau-Terré F, Vicho R, Zapata L, Maynar J, Gil A. [Hemodynamic monitoring in the critically patient. Recomendations of the Cardiological Intensive Care and CPR Working Group of the Spanish Society of Intensive Care and Coronary Units]. Med Intensiva 2013; 38:154-69. [PMID: 24296336 DOI: 10.1016/j.medin.2013.10.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Accepted: 10/20/2013] [Indexed: 12/14/2022]
Abstract
Hemodynamic monitoring offers valuable information on cardiovascular performance in the critically ill, and has become a fundamental tool in the diagnostic approach and in the therapy guidance of those patients presenting with tissue hypoperfusion. From introduction of the pulmonary artery catheter to the latest less invasive technologies, hemodynamic monitoring has been surrounded by many questions regarding its usefulness and its ultimate impact on patient prognosis. The Cardiological Intensive Care and CPR Working Group (GTCIC-RCP) of the Spanish Society of Intensive Care and Coronary Units (SEMICYUC) has recently impulsed the development of an updating series in hemodynamic monitoring. Now, a final series of recommendations are presented in order to analyze essential issues in hemodynamics, with the purpose of becoming a useful tool for residents and critical care practitioners involved in the daily management of critically ill patients.
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Affiliation(s)
- A Ochagavía
- Servicio de Medicina Intensiva, Hospital de Sabadell, CIBER Enfermedades Respiratorias, Corporació, Sanitària Parc Taulí, Institut Universitari Parc Tauli, Universitat Autònoma de Barcelona, Sabadell, Barcelona, España.
| | - F Baigorri
- Servicio de Medicina Intensiva, Hospital de Sabadell, CIBER Enfermedades Respiratorias, Corporació, Sanitària Parc Taulí, Institut Universitari Parc Tauli, Universitat Autònoma de Barcelona, Sabadell, Barcelona, España
| | - J Mesquida
- Servicio de Medicina Intensiva, Hospital de Sabadell, CIBER Enfermedades Respiratorias, Corporació, Sanitària Parc Taulí, Institut Universitari Parc Tauli, Universitat Autònoma de Barcelona, Sabadell, Barcelona, España
| | - J M Ayuela
- Servicio de Medicina Intensiva, Hospital de Burgos, Burgos, España
| | - A Ferrándiz
- Servicio de Medicina Intensiva, Hospital Universitario General de Castellón, Castellón, España
| | - X García
- Servicio de Medicina Intensiva, Hospital de Sabadell, CIBER Enfermedades Respiratorias, Corporació, Sanitària Parc Taulí, Institut Universitari Parc Tauli, Universitat Autònoma de Barcelona, Sabadell, Barcelona, España
| | - M I Monge
- Servicio de Cuidados Críticos y Urgencias, Hospital del SAS Jerez, Jerez de la Frontera, Cádiz, España
| | - L Mateu
- Servicio de Medicina Intensiva, Hospital Universitario General de Castellón, Castellón, España
| | - C Sabatier
- Servicio de Medicina Intensiva, Hospital de Sabadell, CIBER Enfermedades Respiratorias, Corporació, Sanitària Parc Taulí, Institut Universitari Parc Tauli, Universitat Autònoma de Barcelona, Sabadell, Barcelona, España
| | - F Clau-Terré
- Institut Reçerca, Hospital de Vall d'Hebron y Consorci Sanitàri Terrasa, Barcelona, España
| | - R Vicho
- Servicio de Medicina Intensiva, Clínica USP-Palmaplanas, Palma de Mallorca, España
| | - L Zapata
- Servicio de Medicina Intensiva, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - J Maynar
- Servicio de Medicina Intensiva, Hospital Universitario Araba, Vitoria, Álava, España
| | - A Gil
- Servicio de Cuidados Críticos y Urgencias, Hospital del SAS Jerez, Jerez de la Frontera, Cádiz, España
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García X, Sabatier C, Ferrer R, Fontanals D, Duarte M, Colomina M, Artigas A, Vallés J. Differential time to positivity of blood cultures: a valid method for diagnosing catheter-related bloodstream infections in the intensive care unit. Med Intensiva 2011; 36:169-76. [PMID: 22172517 DOI: 10.1016/j.medin.2011.09.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2011] [Revised: 09/13/2011] [Accepted: 09/22/2011] [Indexed: 11/26/2022]
Abstract
PURPOSE The validation in critical patients with short-term catheters of a method for diagnosing catheter-related bloodstream infection (CR-BSI), based on the differential time to positivity (DTP) of blood cultures. METHODS Patients suspected of having CR-BSI were included. Two peripheral vein blood cultures and a catheter hub blood culture were simultaneously carried out. The responsible catheter was removed and tip cultured. Times to positivity of all blood cultures were automatically registered. CR-BSI was diagnosed when all the cultures were positive for the same microorganism and DTP≥120 min. This diagnosis was compared with the one obtained using the standard method. RESULTS 226 cases suspected of CR-BSI were analyzed during a 20-month period. A total of 19 removed catheters were associated with CR-BSI. Seven cases of polymicrobial cultures (4 with CR-BSI) were discarded from the final analysis due to the impossibility of determining the time to positivity for each individual microorganism. Using the DTP method, 12 out of 15 CR-BSI cases were diagnosed (sensitivity 80%, specificity 99%, PPV 92%, NPV 98%). In a ROC curve, we found a cut-off value of 17.7 h in positivity of hub blood cultures that may be useful for diagnosing CR-BSI. CONCLUSION DTP can be a valid method for CR-BSI diagnosis in critically ill patients, avoiding unnecessary catheter withdrawal.
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Affiliation(s)
- X García
- Critical Care Center, Hospital de Sabadell, CIBER enfermedades respiratorias, Institut Universitari Parc Taulí-Autonomous University of Barcelona, Sabadell, Spain.
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García X, Mateu L, Maynar J, Mercadal J, Ochagavía A, Ferrandiz A. Estimación del gasto cardíaco. Utilidad en la práctica clínica. Monitorización disponible invasiva y no invasiva. Med Intensiva 2011; 35:552-61. [DOI: 10.1016/j.medin.2011.01.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2010] [Revised: 01/18/2011] [Accepted: 01/19/2011] [Indexed: 10/18/2022]
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Gálvez M, Ascaso S, Moliner R, Jiménez R, García X, Gordon A, Lázaro M. Catalytic filters for the simultaneous removal of soot and NOx: Effect of CO2 and steam on the exhaust gas of diesel engines. Catal Today 2011. [DOI: 10.1016/j.cattod.2011.01.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Alonso-Deflorida F, Del Castillo J, García X, Gijón E. Mechanism of the schultz-dale reaction in the denervated diaphragmatic muscle of the Guinea pig. ACTA ACUST UNITED AC 2010; 51:677-93. [PMID: 19873612 PMCID: PMC2201195 DOI: 10.1085/jgp.51.5.677] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The mechanism of the contractions elicited by specific antigens in immunologically sensitized muscle tissue (Schultz-Dale responses) has been investigated on single fibers of denervated guinea pig hemidiaphragms. This preparation can be either actively or passively allergized, showing Schultz-Dale responses similar to those of visceral muscle. Specific antigens were applied with an electrically operated microtap to discrete areas of the cell surface while recording the electrical activity with intracellular microelectrodes. In this manner, a depolarizing action of the antigens on the muscle membrane was demonstrated. Brief applications of antigen gave rise to phasic potential changes (antigen potentials) similar to those elicited in the same fibers with acetylcholine-filled microtaps. However, antigen potentials occur only in denervated fibers sensitized to the specific antigen or closely related proteins; they are not seen in either innervated fibers of allergized animals or in denervated, nonallergized fibers. Repeated antigen application to the same area of the fiber causes a local irreversible desensitization. The antigen potentials are associated with a reduction in the resistance of the muscle membrane, similar to that caused by acetylcholine. It is concluded that besides causing the liberation of biogenic amines from the mast cells, antigens exert a direct action on the permeability of the muscle membrane; the molecules of antibody adsorbed to the cells appear to act as specific chemoreceptors for the antigen.
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Affiliation(s)
- F Alonso-Deflorida
- Department of Pharmacology, School of Medicine, University of Puerto Rico, San Juan, Puerto Rico 00905
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Rodríguez-Pérez A, Partida C, Ojeda N, Gil F, García X, Medina C. 749 EVALUATION OF TWO POSTOPERATIVE ANALGESIC REGIMENS IN THE ABDOMINAL LAPAROSCOPIC SURGERY. Eur J Pain 2006. [DOI: 10.1016/s1090-3801(06)60752-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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García X, Soler L, Amer M, Camacho J, Arnalich F. [Twenty one year old male with cachexia and presence of abundant amount of intraabdominal gas]. Rev Clin Esp 2006; 206:355-6. [PMID: 16831385 DOI: 10.1157/13090486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- X García
- Servicio de Medicina Interna, Hospital Universitario La Paz, Madrid, España
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Gijón E, Cartas L, García X. Lead acetate action on anaphylactic response of guinea pig smooth muscle. Proc West Pharmacol Soc 2002; 44:145-6. [PMID: 11793963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Experiments were performed to evaluate lead acetate effects on the anaphylactic contraction in guinea pigs smooth muscles. Aortic rings from guinea pigs exposed to lead acetate developed an anaphylactic contraction significantly lower than the contraction induced by the antigen in controls. In the smooth muscle of the intestine, lead acetate did not modify the anaphylactic response. Lead induced immunosuppression of the anaphylactic response of aortic rings, whereas sodium acetate had no effect on the anaphylactic reaction of the guinea pig smooth muscle. The amplitude of the norepinephrine contraction was not modified by lead nor by sodium acetate.
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Affiliation(s)
- E Gijón
- Department of Physiology, School of Medicine, Universidad Nacional Autónoma de México, AP 70-250, Ciudad Universitaria, México D.F. 04510
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Abstract
The smooth muscle of thoracic aorta from guinea pig sensitized with egg albumin (EA) produced an anaphylactic contraction when it was exposed to EA. Experiments were performed to evaluate stress effects on the anaphylactic contraction in guinea pig aortic rings. Two types of stressors were used as immunosuppressor stimuli: physical restraint and shaking of the animals. Both stressors diminished the amplitude of the Schultz-Dale contraction in aortic rings from sensitized guinea pig. The shake stress stimulus interrupted several times during each session induced higher immunosuppression in animals in which the active sensitization and the stress sessions began the same day. Severe restraint stress, prior to active immunization, also suppressed significantly the anaphylactic response. The Schulz-Dale reaction in guinea pig aorta seems to be a valuable technique to study the stress effects on the anaphylactic response.
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Affiliation(s)
- X García
- Department of Physiology, School of Medicine, Universidad Nacional Autónoma de México, México, D.F.
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Gijón E, Valencia A, Contreras-Barrios MA, Verdugo L, García X. Homologous transplant in vivo of uterine smooth muscle cells in cardiac muscle of guinea pig. Proc West Pharmacol Soc 1998; 41:159-60. [PMID: 9836280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Affiliation(s)
- E Gijón
- Dept. of Physiology, School of Medicine, UNAM, México D.F., México
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Borges JE, Fernández F, García X, Hergueta AR, López C, Andrei G, Snoeck R, Witvrounw M, Balzarini J, De Clercq E. Novel carbocyclic nucleosides containing a cyclobutyl ring. Guanosine and adenosine analogues. Nucleosides Nucleotides 1998; 17:1237-53. [PMID: 9708317 DOI: 10.1080/07328319808004236] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
(1R,cis)-2-(3-Amino-2,2-dimethylcyclobutyl)ethanol (4) was used as a precursor in the synthesis of cyclobutyl nucleoside analogues containing guanine, 8-azaguanine, adenine or 8-azaadenine. All the compounds were evaluated as antiviral agents in a variety of assay systems. Some activity was noted for compound 13, 17, 19 and 20 against vaccinia virus and for compounds 11, 12, 13, 17, 19 and 20 against herpes simplex virus, at concentrations that were up to 10-fold below the cytotoxic concentrations for the host cells.
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Affiliation(s)
- J E Borges
- Departamento de Química Orgánica, Facultade de Farmacia, Universidade de Santiago, Spain
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Abstract
1. The effect of the aqueous extract of Cissus sicyoides (CS) on isolated guinea pig aortic rings was studied. CS contracts the smooth muscle of the aorta in a dose-response relation. 2. The extract of CS increases the norepinephrine contraction in normal calcium and in solutions without calcium. 3. Lanthanum inhibits the contraction induced by CS. 4. The vasoconstrictor effect of CS was increased in solutions without calcium or with low calcium, which is an inverse calcium-dependent contraction. 5. Prolonged exposure to calcium-free solution did not abolish CS contraction. These contractions can be elicited repeatedly even after 6 hr of continuous exposure to calcium-free solutions. 6. Caffeine reduces contractile response induced by CS in normal calcium, as well as in solutions without calcium. 7. Our results support the idea that the aqueous extract of CS acts at the membrane level, increasing the calcium entry through the membrane as well as acting on the internal calcium deposits, possibly on the sarcoplasmic reticulum.
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Affiliation(s)
- X García
- Department of Physiology, School of Medicine, Univesidad Nacional Autonóma de México, Ciudad Universitaria, México, D.F
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Estêvão-Costa JM, Morales L, García X, Parri FJ, Albert A, Grau JM. [Experimental free muscle transplantation. Is autologous graft on the distal esophagus viable?]. Cir Pediatr 1997; 10:74-8. [PMID: 9147470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
UNLABELLED Experimental free muscle transplantation has resulted in some successful clinical applications. AIM The possibility that this type of transplantation could act as a sphincteric mechanism motivated us to start by assessing the viability of autologous skeletal grafts on the distal esophagus of laboratory animals. MATERIAL AND METHODS Twenty transplants of previously denervated free plantaris muscle grafted on the distal esophagus of Sprague-Dawley rats were evaluated at the 1st, 2nd, 4th, 8th and 16th posttransplant week. Histological and histochemical studies were performed to evaluate general features of the grafts and the muscle fibers condition. RESULTS One and two weeks after transplant the grafts show large areas of necrosis with inflammatory infiltrate. Between the 2nd and the 4th week, as revascularization and motor endplates become significant, the areas of necrosis begin to regress and they almost disappear by the 8th week. Since the 4th week after transplant, regenerated muscle fibers demonstrate morphological and biochemical features similar to normal. CONCLUSIONS Experimental free plantaris muscle transplantation on the distal esophagus is viable and shows revascularized and reinnervated muscle fibers from the 8th week after transplant on, and at least until the 16th. These fibers have the structural and metabolic properties enabling contractile function. This original model may allow further investigation of some features related to pathophysiology and therapy of gastroesophageal reflux.
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Affiliation(s)
- J M Estêvão-Costa
- Servicio de Cirugía Pediátrica, Unidad Integrada Hospital Clínico-Hospital San Juan de Dios, Barcelona
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20
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Roqueta MC, Sabaté A, Sopena R, García X, Barceló E, García L, Abad A, Ramón R. [Specificity of CK-MB enzyme in the diagnosis of acute myocardial infarction in the postoperative period following non-cardiac surgery]. Rev Esp Anestesiol Reanim 1995; 42:3-8. [PMID: 7892529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVES 1) To determine plasma concentrations of creatinphosphokinase-MB (CK-MB) enzyme during non-cardiac surgery for detecting postoperative myocardial infarction or ischemia. 2) To assess the specificity of CK-MB levels for the diagnosis of acute myocardial infarction (AMI) in patients undergoing non-cardiac surgery. PATIENTS AND METHOD Three hundred twenty-eight patients were studied prospectively. Inclusion criteria were as follows: 1) presenting cardiac risk factors; 2) major surgery; and 3) presence of associated pathology, unrelated to cardiac pathology. All patients were given an electrocardiogram and CK-MB levels were determined every 8 hours over the first 24 hours and on the second and third days. Total CK was measured at 24 hours. RESULTS AMI was detected by electrocardiogram in 3.3% of the patients. ST-segment/T-wave changes were detected in 5.7% and myocardial ischemia was found in 14.7%. Mean levels of CK-MB in patients with postoperative AMI were significantly higher than in patients without AMI. Total CK levels in patients with electrocardiographic changes were not significantly different from those of other patients. Thoracic surgery produced a significant increase in total CK but no increase in CK-MB. Patients undergoing esophageal surgery presented high initial levels of CK-MB that became normal. CONCLUSIONS 1) The CK-MB/total CK ratio is highly specific for detection AMI after surgery. 2) Type of surgery affects total CK levels. 3) Detection of high levels of MB fraction should lead to a suspicion of myocardial damage. 4) Total CK level is not a good marker of myocardial necrosis in the postoperative period.
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Affiliation(s)
- M C Roqueta
- Servicio de Anestesiología y Reanimación, Ciutat Sanitària de Bellvitge Prínceps d'Espanya, L'Hospitalet de Llobregat, Barcelona
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21
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Estêvâo-Costa JM, Morales L, Parri FJ, García X, Albert A. [Experimental alkaline reflux esophagitis. Role of the refluxed material]. Cir Pediatr 1994; 7:182-7. [PMID: 7532428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Alkaline reflux is new recognised to play an important place in gastroesophageal reflux disease. In order to investigate the role of refluxate in the development of esophagitis we have performed an experimental study in laboratory animals submitted to alkaline reflux inducing operations. We produced esophagitis in two experimental groups of Sprague-Dawley rats: group I, end-to-side esophagojejunostomy (EY) and group II, esophagojejunostomy with partial derivation of afferent loop by an omega-like conduit (EO) designed to attain lesser reflux. Group III consisted of sham laparotomized animals (L). RESULTS. At day 14, all the animals of experimental groups have developed esophagitis, but the macroscopic extent and histological grade in group EO (med: 27 mm; grade 2) were significantly lower than in group EY (med: 35 mm; grade 3). Biochemical measurements (med) in esophageal washout revealed: a) pH were alkaline in all groups with a decrease in experimental groups that was only significant in group EY; b) Amylase, lipase and bile acids in groups EY (8090; 498; 32) and EO (12840; 449; 50) were similar, but significantly more higher than in group L (920; 24; 0). The analysis of correlation between esophagitis parameters and biochemical measurements revealed no significant ones except for pH (r = -.437 and -.417). CONCLUSIONS. 1- The alternative model (EO) presents lesser grade and extent of esophagitis. 2) The refluxate was rich in bile acids and pancreatic enzymes what is proof of the actual occurrence of reflux and supports its determinant contribute to the development of esophagitis. 3) Esophagitis has developed at alkaline pH but with no alkalinity increase in the experimental groups what indicate that "alkaline reflux esophagitis" is not an appropriate denomination. 4) The discrepancy between the biochemical analysis in esophageal washout and the extent and grade of esophagitis suggests that others than the nature and amount of refluxate (e.g. mucosal resistance) could play a role in reflux esophagitis.
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Affiliation(s)
- J M Estêvâo-Costa
- Servicio de Cirugía Pediátrica, Hospital Clínico-Hospital San Juan de Dios, Barcelona
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22
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Sabaté A, Sopena R, Ramón R, Roqueta C, García X, García L, Barceló E, Abad A, Richart JA. [Peroperative myocardial infarction and myocardial ischemia in non cardiac surgery: prevalence and predictive factors]. Med Clin (Barc) 1994; 103:121-4. [PMID: 8072323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND The decrease in the prevalence of infarction in the population has not been accompanied by a reduction in postinfarct mortality, particularly in the population segment which does not present major symptoms of coronary disease. The aim of the present study was to determine the incidence and predictive factors of cardiac complications in patients undergoing non cardiac surgery. METHODS Eight hundred seventy-five patients undergoing elective surgery from May 1990-1991 had some of the following criteria: history of heart disease, major surgery, and medical risk other than cardiac. A sample of 328 patients was selected to whom an ECG an CK-MB isoenzyme test were performed on admission, every 8 h, and at the second and third days. Infarction or ischemia were diagnosed by electrocardiographic and enzymatic criteria. Minimum follow up was 72 hours. RESULTS IAM was diagnosed in 10 cases (3%, confidence interval 95%, 2 to 4%) and ischemia in 47 cases (14%, CI 95%, 11 to 18%). Operative mortality of cardiac origin was 4% (CI 95%, 2 to 6%). Arrhythmia not preoperatively present was detected in 11%, hemodynamic instability in 25%, and sinusal tachycardia in 21%. Other complications were: abdominal 12%, respiratory 14%, neurologic 6% and renal 4%. The appearance of cardiac complications was related with: ASA classification (p < 0.05), previous history of heart disease (p < 0.01), cardiovascular drug administration (p < 0.01) and changes in preoperative electrocardiogram (p < 0.001). CONCLUSIONS The present study suggests that patients with changes of the ST-T segment in the preoperative ECG should undergo examination to determine the degree of cardiac involvement. A strict peroperative hemodynamic control may reduce the prevalence of cardiac complications in those patients at high risk.
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Affiliation(s)
- A Sabaté
- Departamento de Anestesia y Reanimación, Ciutat Sanitària i Universitària de Bellvitge, L'Hospitalet de Llobregat, Barcelona
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23
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García X, Julia V, Morales L, Díaz F, Rovira J, Parri FJ. [Surgical management of congenital tracheal stenosis]. Cir Pediatr 1994; 7:45-7. [PMID: 8204431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
A six month old infant with dextrocardia, butterfly vertebrae and oesophageal atresia type I is reported. After surgical repair, she developed respiratory distress, needing ventilatory support. The bronchoscopy and bronchography demonstrated segmental tracheal stenosis. A resection of the stenotic segment was performed, and tracheal reconstruction with terminoterminal anastomosis. After a period of clinical improvement, respiratory distress came back and reestenosis was ascertained locating its level on the anastomosis. Three sessions of balloon dilation were ineffective and because that it's decided the introduction of a metallic self-expandable stent. After a transient relief, the patient had a bilateral pneumonia ending with the dead of the patient. In spite of the treatment used, it was not possible to accomplish solution in a middle or a large place. This constitutes a clear exponent of the complexity in the management of the congenital tracheal stenosis.
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Affiliation(s)
- X García
- Servicio de Cirugía Pediátrica, Hospital Clínico y Provincial de Barcelona, Universitat de Barcelona
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da Costa JM, Morales L, García X, Parri FJ, Ribalta T, Sancho MA. [Reflux esophagitis in an experimental model. Are the systemic consequences attributable to the esophagitis?]. Cir Pediatr 1993; 6:196-9. [PMID: 8123442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The esophagojejunostomy model of reflux esophagitis has been shown to cause nutritional deterioration and alterations of hematologic parameters. However, these disturbances have been assumed rather than proved to be the consequence of esophagitis. Little attention has been paid to the anatomical and physiological alterations related to the reflux-inducing operation. We produced reflux esophagitis by an end-to-side esophagojejunostomy (EJ) in Sprague-Dawley rats. These rats were compared to a second group with a similar operation not leading to reflux esophagitis (Roux-en-Y esophagojejunostomy, R-Y). Sham operated animals were used as controls. Erosive esophagitis was produced in all but one of the EJ subjects at day 14, and in none of the R-Y animals. Significant weight loss (-21.7%), anemia (HCT, -17.3%) and hypoproteinemia (-14.2%) were seen in EJ model with respect to sham group. However, a similar variation of weight (-28.7%) and hematocrit (-26.2%) were also found in Y-R group; therefore, these parameters seemed to correlate more with the surgical challenge itself than with the esophagitis.
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Affiliation(s)
- J M da Costa
- Serviço de Pediatrica, Pediatria Cirúrgica, Hospital São João, Porto, Portugal
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Torres J, Marco J, Moral V, Battikh I, Mabrok M, García X. [Transitional cutaneous hyperesthesia following block of the ilioinguinal and iliohypogastric nerves]. Rev Esp Anestesiol Reanim 1992; 39:257. [PMID: 1513946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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