Pelillos a la mar / Telltale Hairs

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Timoma de estadio avanzado asociado a síndromes paraneoplásicos con buena respuesta a los corticosteroides orales y tacrolimus tópico / Advanced-Stage Thymoma Associating Multiple Paraneoplastic Syndromes with Good Response to Oral Corticosteroids and Topical Tacrolimus

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Asfixia grave en una lactante por uso incorrecto del «pañuelo portabebés» / Infant suffocation associated with the incorrect use of a baby sling

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[Variation of central corneal thickness in diabetic patients as detected by ultrasonic pachymetry]. / Variación del espesor corneal central en pacientes diabéticos mediante paquimetría ultrasónica.

OBJECTIVE: To prove the existence of a correlation between central corneal thickness and diabetes. METHODS: Ultrasound pachymetry measurements were made in 1,000 patients. The sample was divided into two groups of patients: 953 of them were non-diabetic patients, and 47 were diabetic patients. RESULTS: The average central corneal thickness in diabetic patients was 571.96 +/- 26.81 microns with a range between 514 and 626. The average central corneal thickness found in non-diabetic patients was 544.89 +/- 35.36 microns with range of 448 to 649. The increase in central corneal thickness found in diabetic patients compared to non-diabetic patients was statistically significant (p<0.001, Student "t" test). CONCLUSIONS: We found that diabetic patients had an increased central corneal thickness when compared with non-diabetic patients.

Variación del espesor corneal central en pacientes diabéticos mediante paquimetría ultrasónica / Variation of central corneal thickness in diabetic patients as detected by ultrasonic pachymetry

Objetivo: Demostrar la existencia de una relación entre el espesor corneal central y los pacientes diabéticos. Métodos: Se utilizó un paquímetro ultrasónico para medir el espesor corneal en 1000 pacientes. Dividimos los pacientes en dos grupos: 953 no diabéticos y 47 pacientes diabéticos. Resultados: La paquimetría central media encontrada en los pacientes diabéticos fue 571,96 ± 26,81 micras con un rango comprendido entre 514 y 626. La paquimetría central media hallada en el grupo de no diabéticos fue 544,89 ± 35,36 micras con un rango desde 448 hasta 649. Encontramos un aumento del espesor corneal central estadísticamente significativo (p<0,001, test «t» student) en el grupo de pacientes diabéticos al compararlos con los no diabéticos. Conclusiones: Hemos encontrado que los pacientes diabéticos presentan un espesor corneal central medio mayor frente a los pacientes no diabéticos

Objective: To prove the existence of a correlation between central corneal thickness and diabetes. Methods: Ultrasound pachymetry measurements were made in 1,000 patients. The sample was divided into two groups of patients: 953 of them were non-diabetic patients, and 47 were diabetic patients. Results: The average central corneal thickness in diabetic patients was 571.96 ± 26.81 microns with a range between 514 and 626. The average central corneal thickness found in non-diabetic patients was 544.89 ± 35.36 microns with range of 448 to 649. The increase in central corneal thickness found in diabetic patients compared to non-diabetic patients was statistically significant (p<0.001, Student «t» test). Conclusions: We found that diabetic patients had an increased central corneal thickness when compared with non-diabetic patients

Educación del paciente con cervicalgia / Patient's education with neck pain

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Electrophysiological effects of lidocaine, l-chlorpheniramine, and bepridil on rabbit sinus node pacemaker cells.

We compared the electrophysiological effects of lidocaine, l-chlorpheniramine, and bepridil on rabbit sinus node pacemaker cells. Only bepridil (0.25-2.0 mg/L) caused a marked reduction in the automaticity of the sinus node. Action potential amplitude, overshoot, and maximum rate of depolarization of phase O (MRD) were all reduced in a dose-dependent manner by bepridil. Decreases in maximum diastolic potential (MDP) and take-off potential were also observed, the former falling to approximately -40 mV when automaticity ceased. On the other hand, lidocaine (12-48 mg/L) depressed the upstroke of the action potential without significantly affecting MDP or take-off potential. The action potential duration was also prolonged at these concentrations. Both MDP and take-off potential were markedly reduced by l-chlorpheniramine (2.9-11.6 mg/L) and these changes were accompanied by reductions in amplitude, overshoot, and MRD of the action potential. A prolongation of the action potential duration was also observed. Pacing the sinus node preparations at a frequency of 4.5 Hz depressed the upstroke of the action potential and led to postoverdrive suppression. l-Chlorpheniramine abolished the postoverdrive suppression, whereas in the presence of lidocaine and bepridil a marked reduction and alternation in action potential amplitude occurred on pacing which made the accurate assessment of sinus node recovery time impossible.

Electrophysiological effects of lidocaine, l-chlorpheniramine, and bepridil on normal and ouabain-intoxicated canine Purkinje fibers.

We compared the electrophysiological effects of lidocaine, l-chlorpheniramine, and bepridil on both normal and ouabain-induced automaticity of canine Purkinje fibers. All three drugs suppressed the automaticity of spontaneously beating Purkinje fibers, but only lidocaine and bepridil reduced the amplitude of delayed afterdepolarizations induced by ouabain. Whereas lidocaine caused equal decreases in delayed afterdepolarization amplitude initiated at cycle lengths of stimulation between 1,000 and 250 ms, bepridil reduced their amplitude more at short than at long cycle lengths. Similarly, bepridil's but not lidocaine's effects on action potential characteristics were also dependent on the cycle length of stimulation; more marked decreases in amplitude and rate of rise of the action potential being observed at short cycle lengths. Lidocaine, alone, also markedly prolonged the period of overdrive suppression.

[Actions of chlorpheniramine and its isomers on the auricular fibers of the mammalian heart]. / Acciones de la clorofeniramina y sus isómeros sobre las fibras auriculares del corazón del mamífero.

The effects of the antihistaminic agent, chlorpheniramine and its optical isomers, were studied on the transmembrane potentials of specialized atrial conducting tissue and ordinary auricular muscle fibers. On atrial myocardium fibers, both isomers increase the duration of the action potential to a different degree and they also reduce the maximum rate of rise of phase O or dV/dt. In specialized conducting atrial tissue, the levo isomer increase the duration of the action potential in a larger proportion than the dextro compound. This occurs at the expense of the repolarization process. The l-compound produces only minimal changes in the dV/dt. The effects observed on both types of atrial tissues leads us to conclude: 1) Either type of tissue responds differently to each optical isomer of chlorpheniramine; 2) the results confirm the participation of specialized conduction pathways in atrial flutter; 3) the levo isomer may be considered as a possible candidate for clinical trial in patients with atrial flutter.

Acciones de la clorofeniramina y sus isomeros sobre las fibras auriculares del corazon del mamifero. / Effects of chloropheniramine and its isomers on atrial tissue of mammalian heart

Mediante el uso de tecnicas de registro intracelular con microelectrodos analizamos el efecto del antihistaminico clorofeniramina y sus isomeros, sobre los potenciales bioelectricos intracelulares de dos distintos tejidos de la auricula del perro: el miocardio auricular ordinario y el tejido auricular especializado de conduccion formado por el haz interauricular de Bachmann y los haces internodales. En las celulas del miocardio auricular ordinario, los dos isomeros aumentan en distinto grado la duracion del potencial de accion. Reducen tambien la maxima velocidad de despolarizacion o dV/dt. En las celulas del tejido auricular especializado de conduccion, el isomero levogiro aumenta en mayor proporcion la duracion del potencial de accion a expensas del proceso de repolarizacion este efecto ocurre con minimos cambios en la maxima velocidad de despolarizacion o dV/dt.Los efectos observados sobre los dos tejidos auriculares estudiados nos permiten formular las siguientes conclusiones: 1) Cada tejido responde en forma distinta ante cada forma optica de clorofeniramina; 2) Los datos obtenidos reafirman la participacion de los haces de tejido auricular de conduccion en el flutter auricular; 3) El isomero levogiro de la clorofeniramina puede considerarse como posible candidato a su ensayo en el flutter auricular de la clinica

[Experimental anti-arrhythmic action of perhexiline]. / Acción antiarrítmica experimental de la perhexilina

The antiarrhythmic action of Perhexiline phosphate, in doses of 3 and 6 mg/kg on various experimental cardiac arrhytmias and on the physiological properties of the atrial myocardium has been studied in the anesthetized dog. Its action in concentrations of 3 and 6 mcg/ml on the transmembrane action potentials in isolated Purkinje fibers has also been analyzed. The activity of perhexiline is comparatively greater in the circus movement atrial flutter and in the arrhythmias caused by ouabain and by barium chloride intoxication than in the atrial tachysystolia caused by the local application of aconitine. Perhexiline prolongs the wave length (refractory period times conduction velocity) of the atrial impulse and depresses atrial excitability. These effects may explain its action on experimental atrial flutter. In isolated Purkinje fibers, perhexiline reduces the maximum velocity of depolarization, the overshoot, the amplitude of the action potential and its duration, measured at 50% of its repolarization phase. The relation of these electrophysiological effects of perhexiline to the genesis of each type of arrhythmia may explain its different type of activity in the experimental models studied.

The effects of ajmaline in experimental and clinical arrhythmias and their relation to some electrophysiological parameters of the heart.

The antiarrhythmic efficacy of ajmaline has been evaluated in three experimental models of cardiac arrhythmias in the dog. These data have been related to the actions of the compound on several parameters of heart function and compared to results obtained in various clinical arrhythmias. Ajmaline was more effective in arrhythmias of the ectopic focus type than in the circus movement model. These results agreed with the pattern of clinical activity. The compound produced decreases in excitability and conduction and increased the functional refractory period in all heart tissues. These effects were most marked in the atrium. The drug also showed a moderate degree of anticholinergic activity. Both in the dogs and in the clinical cases, the agent showed an important hypotensive effect. In a group of experiments in which transmembrane potentials were recorded, the compound produced in all tissues a decrease in upstroke velocity and amplitude of the action potential; it also increased the duration of the action potential in atrial and ventricular muscle, but it decreased it in Purkinje fibers. The possible mechanism(s) of action of the drug is discussed in terms of the different hypotheses for cardiac arrhythmias.