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A Casals

Publications and source records attributed to A Casals.

At least 19 recordsLinked to original sources
PubMed2006

Deregulation of tissue homeostasis in endometria from patients with polycystic ovarian syndrome with and without endometrial hyperplasia.

OBJECTIVE: To study the proteins involved in endometrial homeostasis in PCOS women. METHODS: Protein expression of Ki67, Bcl-2, Bax, Pro-Caspase-3 and Caspase-3 by immunohistochemistry and/or Western blot, and DNA fragmentation using in situ 3'-end labeling of apoptotic cells, was measured in 9 samples of normal endometrium (NE), 12 PCOS endometria without treatment (PCOSE), 7 endometria from PCOS women with endometrial hyperplasia (HPCOSE) and 9 endometria from patients with endometrial hyperplasia (HE). RESULTS: Cell proliferation was higher in epithelium from PCOSE (P<0.05), HPCOSE and HE vs NE. A higher Bcl-2/Bax relative ratio in PCOSE and HPCOSE was observed, in absence of active Caspase-3 and scarce DNA fragmentation in the four groups of endometria studied. CONCLUSION: As the apoptosis was scarce in all of the groups studied, endometrial homeostasis deregulation in PCOS could be a result of increased proliferation. Therefore, the onset of endometrial hyperplasia in PCOS endometrium could be linked to inadequate cell proliferation, and concomitantly to inadequate cell survival.

Adult↗
PubMed1993

Occult cancer in patients with acute pulmonary embolism. A prospective study.

We prospectively studied 78 consecutive patients with acute pulmonary embolism (PE) to determine the most appropriate workup study for searching for hidden cancer. After a careful physical examination, the following tests were performed: erythrocyte sedimentation rate (ESR), complete blood cell counts, biochemistry, carcinoembryonic antigen levels, chest radiograph, upper gastrointestinal endoscopy, and abdominal ultrasound. If a malignant lesion was suspected, further appropriate tests were performed. After hospital discharge, periodic follow-up was performed on all patients in our outpatient clinic. A malignant lesion was detected in 9 of 78 patients: in 7 of them, cancer was diagnosed during the hospital admission because of acute PE. All but one of these 7 patients were asymptomatic, except for PE symptoms. In three of them some abnormalities on physical examination led to the diagnosis of cancer; in the remaining three patients the diagnosis was suspected from abnormal results of blood tests. Cancer was detected several months after hospital discharge in two additional patients: an esophageal cancer was diagnosed 5 months later in one of the 23 patients who refused endoscopy; and a colonic carcinoma was detected 21 months after hospital discharge in a patient in whom colonoscopy was not performed at the time of hospital admission. When considered overall, cancer was more commonly found in patients with "idiopathic" PE as compared with patients with known risk factors for PE development (6 of 21 patients vs 3 of 51 patients; p < 0.05). On the other hand, one patient died because of massive recurrent PE after a biopsy sample was obtained because of a prostatic node. Gross hematuria had developed shortly after biopsy, and any attempt to increase heparin doses was followed by recurrent hematuria. According to our experience, any decision about procedures that potentially involve bleeding should be carefully individualized in patients with acute PE.

Acute Disease↗
PubMed1993

[Clinical and microbiological study of acute pelvic inflammatory disease].

Upper genital tract infection was investigated in 46 women admitted to hospital with clinic diagnosis of acute pelvic inflammatory disease (PID) and 62 control women accepted to hospital for laparoscopy Fallopian tubes sterilization. Diagnosis was ratified by laparoscopy in mild and moderate salpingitis; culdocentesis and ultrasonography were performed in severe salpingitis and endometrial sample was made in endometritis. Microbiological specimens were taken from the cervix and abdomen. Antecedents and complete clinical studies were obtained. Patients were treated with antibiotic association sodic G penicillin, chloramphenicol and gentamicin. Risk factors to development PID were: single female (p < 0.05), multiple sexual partner (p < 0.01), previous PID (p < 0.05), infertility (p < 0.05), mean year of IUD use in severe salpingitis (p = 0.05) and mean years of age from women with sexually transmitted bacterias (STB) vs endogenous bacterias (EB) (p < 0.05). In the control group no abdomen bacterias were isolated. In patients with PID, C. trachomatis was detected by serology in 28.3%. N. gonorrhoeae was isolated from the cervix in 23.9% and from the abdomen 17.4%. Besides it was isolated from the abdomen: M. hominis 17.3% and E. coli 15.2%. STB were isolated in 54.3% and EB in 47.8% of the patients. Bacterial association was present on the 37%. Cervix isolation of G. vaginalis and Mycoplasma were not correlated with development of PID. Cervix microbiological samples were useful to know abdomen microbic etiology. They coincide with those in the 90.9%. EB were more frequently isolated from severe salpingitis (p = 0.05) and STB from mild and moderate salpingitis (p = 0.05). Antibiotic association cured all the mild and moderate salpingitis with independence of bacterial etiology. Failure occurred in 2 diffuse peritonitis and 13/14 tubo-ovarian abscesses. Surgery used in severe salpingitis and diffuse peritonitis, principally consisted in anexectomy, peritoneal toilet and drainages. No hysterectomies were performed. Colpotomy drainage was used as a laparotomy complement or as unique drainage. Severe complications of surgery occurred in 10.5%. Failure in antibiotic treatment, surgery and complications were present with preference in PID with EB. After PID 26.5% of women had both Fallopian tubes damaged; in 39.7% tube damage was not evaluated and in 34.2% one tube rested in health. Damage did not depend of bacterial etiology. Conclusion on the necessity of adequate prevention of this disease and it should need education related to the roll of STB and standards about the IUD use.

Abdomen↗
PubMed1991

Occult cancer in patients with deep venous thrombosis. A systematic approach.

The authors prospectively studied 113 consecutive patients with deep venous thrombosis of the lower extremities to determine the most appropriate workup study for searching for a hidden cancer. After a careful physical examination, the following routine tests were performed: erythrocyte sedimentation rate (ESR), whole blood counts, biochemistry, carcinoembryonic antigen (CEA) levels, chest radiograph, upper gastrointestinal endoscopy, abdominal ultrasound and computed tomography (CT) scan. If a malignant lesion was suspected, further appropriate studies were performed. After discharge, periodic follow-up was performed on all patients in the outpatient clinic. A malignant neoplasm was detected in 12 patients. Of these 12 patients, six were asymptomatic with the exception of experiencing thrombophlebitis. Cancer was found more commonly in patients with idiopathic deep vein thrombosis (DVT) (7 of 31 versus 5 of 82 patients with secondary DVT; P = 0.012), and in those patients with abnormal lactic dehydrogenase (LDH) levels (6 of 23 versus 6 of 90; P = 0.007). Abnormal CEA levels allowed diagnosis of two cases of colonic cancer (on colonoscopy). Both ultrasound and CT scan of the abdomen showed two cases of urinary bladder carcinoma at a very early stage. Furthermore, two cases of adenomatous polyps in colon were found, a condition considered by most authors to be a colorectal cancer precursor. In addition, there were five patients with large benign pelvic tumors, and two patients with absent inferior vena cava. The most striking finding was that some cases of cancer were at a very early stage. It was concluded that blood cell counts, LDH, CEA, chest radiograph, and abdominal ultrasonography (or CT scan) should be routinely performed on all patients with deep venous thrombosis (particularly those with idiopathic DVT). Malignancy would not have been recognized in some patients if these tests had not been performed.

Adult↗
PubMed1991

Role of granulocytes in the development of venous thrombosis in patients with hip fractures.

In a previously reported study we compared the use of a low-molecular-weight heparin (LMWH) and conventional heparin in the thromboprophylaxis of patients with hip fracture. In an attempt to establish additional factors which could aid in predicting the development of deep-venous thrombosis (DVT), we retrospectively studied several clinical and laboratory variables and found that granulocyte count on admission was higher in patients without subsequent postoperative DVT. Forty additional patients were included in a further prospective study in order to validate our previous findings. 38% of patients who developed DVT had a granulocyte count lower than 9,500/microliters, whereas only 18% of those patients with DVT had a count higher than 9,500/microliters. These figures imply a positive predictive value of 38% and a negative predictive value of 82%. We suggest that granulocytes could play a role in the development of DVT and preoperative granulocyte count may be used to detect a high-risk population for DVT after a hip fracture.

Adult↗
PubMed1991

Platelet count and venous thromboembolism. A useful test for suspected pulmonary embolism.

We have previously reported that patients with deep vein thrombosis (DVT) and scintigraphic evidence of pulmonary embolism (PE) had a fall in platelet count, as compared with their levels before thrombosis had developed. Otherwise, no changes were found in DVT patients without embolism. We recently conducted a prospective study with a larger series of patients and studied platelet count behavior in 189 consecutive patients with acute venous thromboembolism (VTE) in whom a baseline blood cell count was available (obtained before thromboembolism developed). We found no significant differences in baseline platelet counts between groups. However, at the time of VTE diagnosis the analysis of variance demonstrated that mean platelet count was significantly higher in patients without embolism as compared with PE patients (p less than 0.001). On the other hand, no differences were found between patients with silent PE and those with clinically obvious PE. When patients with postoperative VTE and those with nonpostoperative VTE were analyzed separately, mean platelet count increased only in postoperative DVT patients without embolism (p less than 0.001). In the absence of a previous intervention, DVT did not produce any change in platelet count, while PE significantly reduced platelet number (p less than 0.008). In DVT patients without respiratory symptoms of embolism, we suggest that a lung scan should be performed when platelet count is lower than baseline value. For patients with a higher count, the probability of finding PE is very low, and scintigraphy is not cost-effective.

Adolescent↗
PubMed1991

[AIDS and pregnancy. The clinical management of 2 cases of HIV infection].

Two clinical cases of HIV-infected pregnant women are presented: One with declared AIDS and the other a symptomless carrier. The clinical management of these cases are described; that is, the resolution of the delivery and the clinical measures implemented during their hospitalization. Both, the potential ways of propagating the infection among the health workers as well as the universal precautions which must be taken in order to avoid the risk of infection are discussed. The perinatal transmission of the HIV virus and the possible risk factors are also studied in this presentation. In the heterosexual relations of the couples infected with HIV are considered important their associated risk factors. It appears that education is the primary factor to prevent the infection in obs-gyn patients, more than obtaining resources to do massive serological tests on them.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[HTLV-I in patients from Barcelona with connective tissue diseases, neurologic demyelinating diseases and lymphoproliferative syndromes].

The presence of antibodies against HTLV-I was investigated with ELISA and Western blot techniques in 76 patients with lymphoproliferative syndromes (n = 53), idiopathic subacute myelopathies (n = 4), chronic T-lymphocytosis (n = 3) and collagen vascular diseases (n = 16) diagnosed in the Barcelona area. 9 HIV seropositive patients were included: 7 with lymphoma, 1 with chronic T-lymphocytosis and 1 with polymyositis. Although 3 samples were repeatedly positive with ELISA, none was confirmed with Western blot. These results suggest that in our country, contrasting with areas where HTLV-I infection is endemic, acute and chronic lymphoproliferative diseases, collagen vascular diseases and demyelinating neurologic diseases are not associated with HTLV-I infection. The development of lymphoma in patients seropositive for HIV also could not be related with HTLV-I infection.

Adult↗
PubMed1989

[Risk groups in AIDS].

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Acquired Immunodeficiency Syndrome↗
PubMed1989

[Usefulness of microscopic study of the duodenal bile in the diagnosis of pancreatitis of unknown cause].

In spite of the numerous causes of acute pancreatitis reported, among which the most frequent are biliary lithiasis and alcoholism, the etiology remains obscure in many patients, being termed idiopathic in these cases. The presence of microcalculi in the bile juice has been described as a cause of some pancreatitis initially labeled as of unknown cause. We studied the duodenal bile juice of 22 patients who were admitted on various occasions for acute pancreatitis, in whom the etiology could not be clarified in spite of the anamnesis and explorations. Microscopic study of the bile juice showed the presence of microlithiasis in 36.3% of cases. We conclude that microscopic study of the bile juice is a risk-free technique that should be included systematically in the investigation of the etiology of idiopathic pancreatitis.

Acute Disease↗
PubMed1989

[Emergency endoscopic sclerosis in active hemorrhage caused by esophageal varices: analysis of 31 cases].

We have reviewed our experience in urgent endoscopic sclerosis of bleeding esophageal veins in most patients (67.7%) secondary to alcoholic liver cirrhosis. Through the flexible gastroscope, 1% of polydocanol was injected intra and periveinaly for sclerosis. Initial and primary hemostasis was achieved in 90.3% and 87% of the cases respectively. Hemorrhage recurred in 14.2% of the patients. Hospital mortality was 38.7% (11 patients classified in Childs group C and 1 patient in group B), although only 19.3% of the patients died because of esophageal vein bleeding. These results suggest that in a satisfactory percentage of cases urgent sclerosis of esophageal veins controls active bleeding, and the hospital mortality depends mainly on the severeness of liver failure in these patients.

Adult↗