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Biomedical subjects

A Castella

Publications and source records attributed to A Castella.

At least 19 recordsLinked to original sources
PubMed2005

Primary and secondary closure of the surgical wound after removal of impacted mandibular third molars: a comparative study.

Primary and secondary closure techniques after removal of impacted third molars were compared in terms of post-operative pain and swelling. Two hundred patients with impacted third molars were randomly divided into two groups of 100. Panoramic radiographs were taken to assess degree of eruption and angulation of third molars. Teeth were extracted, and in Group 1 the socket was closed by hermetically suturing the flap. In Group 2 a 5-6 mm wedge of mucosa adjacent to the second molar was removed to obtain secondary healing. Swelling and pain were evaluated for 7 days after surgery with the VAS scale. The statistical analysis (*analysis of variance for repeated measures, P < 0.05) showed that pain was greater in Group 1, although it decreased over time similarly in the two groups (P = 0.081, F(6,198) = 3.073*). Swelling was significantly worse in Group 1 (P < 0.001, F(6,198) = 44.30*). In Group 1, dehiscence of the mucosa was present in 33% of patients at day 7, and 2% showed signs of re-infection with suppurative alveolitis at 30 days. Pain and swelling were less severe with secondary healing than with primary healing.

Adult↗
PubMed2003

Preventability of percutaneous injuries in healthcare workers: a year-long survey in Italy.

The aim of the study was to examine the preventability of percutaneous injuries either through the adoption of correct behaviour or by the use of needles with safety features. We analysed the report forms of occupational needlestick or sharps injuries in a sample of healthcare workers exposed to the risk of percutaneous injuries in the period between 1 June 2000 and 31 May 2001; the forms were returned to the regional SIROH (Italian Study on Occupational Exposure to HIV) centre in which all hospitals of the Piemonte region (Italy) participate. Percutaneous injuries caused by needles (injection, phlebotomy, infusion), suture needles and scalpels were analysed; three samples were extracted according to the type of device that caused the injury. In the sample of 439 needlestick-related percutaneous injuries, 74% were caused by incorrect health worker behaviour and 26% were unpreventable, seventy-nine percent of accidents caused by incorrect behaviour and 24% of accidents could have been prevented by using needles with safety features. In the sample of 221 suture needle and 114 scalpel injuries, incorrect health worker behaviour was identified in 26.2% and 14%, respectively, and unpreventable causes in 73.8% and 50.9%, respectively. A high rate of percutaneous injuries, especially those involving needles for injection, phlebotomy, infusion, and scalpels, could be prevented by adopting safe work behaviour practices and using personal protection equipment. The introduction of devices with safety features could lead to a significant reduction in the number of injuries from needles.

Health Personnel↗
PubMed2001

Pattern of malignant lymphoma in the United Arab Emirates--a histopathologic and immunologic study in 208 native patients.

The aim of this study was to analyze the distribution of the various pathologic types of lymphoma in a native Arab population of the United Arab Emirates (UAE). Two hundred and eight patients with malignant lymphoma diagnosed over a 12-year period (1988-1999) were retrospectively studied morphologically and immunohistochemically with a panel of monoclonal antibodies and classified according to the revised European-American classification of lymphoid neoplasms (REAL). Of the 208 patients in the study, 41% had Hodgkin's disease (HD) and 59% had non-Hodgkin's lymphoma (NHL). The distribution of HD showed a predominance of nodular sclerosis and mixed cellularity types. Among NHLs, the most frequent type was diffuse large B cell (59% of all NHLs) followed by the Burkitt's type (13%). The proportion of primary extranodal NHL was 29%. Immunologically, the percentages of NHL with B-cell and T-cell phenotypes were 83 and 11, respectively. When the International Working Formulation was used, 34% of NHLs were classified as high grade, 59% as intermediate grade and only 7% as low-grade lymphomas.

Adolescent↗
PubMed1999

Mumps: a current epidemiologic pattern as a necessary background for the choice of a vaccination strategy.

Before the measles mumps rubella (MMR) vaccination was widely offered, the epidemiologic data about mumps (morbidity, immunization level, vaccine coverage) were analyzed in Piedmont region (Italy). The disease had a 3- to 5-year epidemic recurrence with morbidity rate between 40 and 150/100,000; the surveillance conducted by 'sentinel' pediatricians showed that the notifications underestimated the real data by about 5- to 7-fold. The 12-year-old subjects showed an immunization level (reached by the disease or the vaccination) of about 50% and their parents tended to refuse the MMR vaccination. Only 54% of the 3- to 5-year-old children received the MMR vaccine in the second year of life and the frequency of the vaccination failure was about 10%. The strategy of vaccination should take into account this epidemiologic pattern, to program an offer adequate to reach mumps control/elimination; the strategy of our region should include the active offer in the second year of life to reach higher coverage, a second offer at 4-6 and/or 12 years of life, when other vaccinations are given and the choice of a highly efficacious vaccine. The improvement of the notification system could also allow a more sensitive surveillance of epidemiologic patterns.

Adolescent↗
PubMed1999

Factor VII deficiency detected in pregnancy: a case report.

Factor VII deficiency is a rare hereditary coagulation disorder with an incidence estimated at 1 in 500,000 individuals. In this report, we describe the 13th case in pregnancy. The diagnosis of severe factor VII deficiency (factor VII level <5%) was established at 10 weeks' gestation after initial laboratory testing showed a markedly prolonged prothrombin time and a normal activated partial thromboplastin time. There was a history of two preterm deliveries, but there was no evidence of previous bleeding manifestations. Antenatal progress of the index pregnancy was unremarkable. Prophylactic treatment with fresh frozen plasma was started at the onset of labor and the patient had a vaginal delivery of a live girl at 36 weeks' gestation. There was no postpartum hemorrhage and mother and newborn were discharged in good condition. The patient's postpartum level of factor VII remained undetectable. Two aspects are outlined: the absence of any significant increase in factor VII clotting activity during this pregnancy and the need to give replacement therapy at labor in patients with severe factor VII deficiency to decrease the risk of postpartum hemorrhage.

Adult↗
PubMed1997

Left atrial size is the major predictor of cardiac death and overall clinical outcome in patients with dilated cardiomyopathy: a long-term follow-up study.

HYPOTHESIS: This study was undertaken to determine whether echo-derived left atrial dimension and other echocardiographic, clinical, and hemodynamic parameters detected at the time of entry into the study may influence prognosis in patients with dilated cardiomyopathy during a long-term follow-up. METHODS: This was a prospective cohort analysis of 123 patients with dilated cardiomyopathy. Clinical evaluation, chest x-ray, M-mode and two-dimensional echocardiogram, exercise test, 72-h ambulatory electrocardiogram monitoring, and cardiac catheterization study were performed in all patients. The study was divided into two phases: in the first phase, patients were divided into two groups according to the left atrial size (> or = 45 mm; < 45 mm), with cardiac death as the end point. In the second phase, all patients were further divided into two groups according to their clinical course. A multivariate analysis was performed to determine independent correlated parameters of cardiac mortality and overall clinical outcome. RESULTS: Cardiac mortality rate was 47.9%: 29% in the group without left atrial dilation and 54.3% in the group with dilated left atrium. Multivariate analysis revealed that left atrium > or = 45 mm, New York Heart Association functional classes III/IV, and the presence of one or more episodes of ventricular tachycardia at Holter monitoring were independent predictors of cardiac mortality, while left atrium > or = 45 mm, left ventricular end-diastolic pressure > 17 mmHg, and exercise tolerance < or = 15 min were independent predictors of poor clinical outcome. CONCLUSIONS: Our results revealed that left atrial size is the principal independent predictor of prognosis in patients with dilated cardiomyopathy in that patients with left atrial dilation had an increase in mortality and a worse clinical outcome compared with those without left atrial dilation.

Adult↗
PubMed1995

Bilateral renal oncocytomatosis in a patient with renal failure.

Bilateral multifocal renal oncocytomas are very rare disorders with only 6 previously reported cases in the world literature, of which only 3 have had pathologic confirmation. We present the first reported case of diffuse, bilateral, multifocal renal oncocytomatosis in a patient with end-stage renal disease requiring hemodialysis. Our patient was found to have hundreds of nodular tumors in both kidneys on exploration, representing the second such reported finding.

Adenoma, Oxyphilic↗
PubMed1992

[Familial occlusion of central veins associated with type II familial hyperlipoproteinemia].

We report, for the first time to the best of our knowledge, about a family in which 3 members (two of which were under 40 years of age) of two successive generations presented central retinal vein occlusions in relation to a type II hyperlipoproteinaemia. On the basis of the reported cases, it can be postulated that hyperlipoproteinaemia seems to be a serious potential risk factor for central retinal vein occlusion. The particular aspects of central vein occlusion in relation to hyperlipoproteinaemia are the elevated frequency of recurrences, the poor visual prognosis secondary to severity of veinous obstruction, and the increased incidence of these occlusions in younger patients. The discovery of a hyperlipoproteinaemia in young patients with central retinal vein occlusion should therefore incite prompt examination of other family members in order to initiate prophylactic hypolipaemic treatment.

Aged↗
PubMed1990

Malignant plasma cell tumors in human immunodeficiency virus-infected patients.

The development of malignant neoplasms in patients with the acquired immune deficiency syndrome (AIDS) or with a positive human immunodeficiency virus (HIV) antibody test is a well known phenomenon. According to the guidelines from the Centers for Disease Control (Atlanta, GA), the presence of intermediate-grade or high-grade B-cell non-Hodgkin's lymphoma in HIV antibody-positive patients is considered a diagnostic criterion for AIDS. The authors describe two cases of malignant plasma cell tumors in two young HIV-infected patients. In light of this and other reports of plasma cell tumors in patients at risk for AIDS or with a positive HIV antibody test, the finding of another manifestation of B-cell neoplasia in these patients may enlarge the spectrum of AIDS-related tumors.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Expansion of large granular lymphocytes (natural killer cells) with limited antigen expression (CD2+, CD3-, CD4-, CD8-, CD16+, NKH-1-) in a human immunodeficiency virus-positive homosexual man.

Lymphoid neoplasms associated with acquired immune deficiency syndrome (AIDS) are mostly of B-cell type and rarely of T-cell origin. The authors report a case of a homosexual HIV antibody-positive, HTLV-1 antibody-negative man who developed T-lymphoproliferative disorder (TGLD) after he experienced a viral-like illness. The lymphoproliferative disorder was characterized by increased peripheral blood large granular lymphocytes (LGL) with azurophilic granules (natural killer [NK] cells) which had limited antigen expression: CD2+, CD3-, CD4-, CD8-, CD16+, NKH-1-. The LGL failed to express T-cell or T-cell-related antigens, with the exception of CD2. No functional or gene rearrangement studies were performed on the patient's lymphocytes. However, the results of immunophenotyping, including CD25, W26, and HLA-DR, were suggestive of an inactive state, and the negative finding for CD3 antigen was consistent with unarranged gene T-cell receptors. This is the first reported case of TGLD in an HIV antibody-positive patient.

Adult↗
PubMed1989

Hybrid acute leukemia in an HIV-antibody-positive patient.

Although the great majority of acute leukemias have been designated as being of lymphocytic or myelocytic origin, recent reports have described elements of both in some patients. We describe here the first case of hybrid acute leukemia in an HIV-antibody-positive patient as well as the first hybrid involving B-cell (Burkitt) acute lymphocytic leukemia and acute myelomonocytic leukemia proven by cytochemical, immunologic, and cytogenetic methods. This case illustrates the increasingly complex difficulties in the diagnosis and treatment of AIDS-related malignancies.

Acute Disease↗
PubMed1989

B-cell acute lymphocytic leukemia in HIV-antibody-positive patients.

B-cell non-Hodgkin lymphoma (NHL) has been well described in association with human immunodeficiency virus (HIV) and the acquired immunodeficiency syndrome (AIDS). Many of these lymphomas are of the diffuse, aggressive, subtype B-cell NHL, including Burkitt and Burkitt-like lymphoma. Recently, there have been reports of B-cell acute lymphocytic leukemia (ALL), Burkitt type, in patients who were either HIV antibody-positive or at high risk for AIDS. We have seen three cases of B-cell ALL, Burkitt type, and herein describe their clinical and laboratory characteristics. All patients were HIV antibody-positive. Since stage IV Burkitt lymphoma in blood phase and B-cell ALL, Burkitt type, represent a continuum of the same disease, and since it is also an aggressive B-cell malignancy, we suggest that B-cell ALL, Burkitt type, in HIV antibody-positive patients should support the diagnosis of AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Evaluation of the automated leukocyte differential count in emergency department patients.

This study compares the results of the leukocyte three-part differential count as determined by the Coulter S-Plus IV in 104 consecutive patient samples from the emergency department with results obtained by conventional visual differential. A high rate (40%) of instrument rejection was found, reflecting the high prevalence of disease and hematologic abnormalities in the patient population. No clinically significant abnormality went undetected, demonstrating that the automated leukocyte three-part differential is effective as a screening test in the emergency department patient population.

Emergency Service, Hospital↗
PubMed1986

Light chain myeloma with meningeal and pleural involvement.

A 76-year-old woman with newly diagnosed lambda light chain myeloma was found to have involvement of the pleura and meninges. Direct immunofluorescence demonstrated the monoclonal nature of plasma cells found in the pleural fluid; morphologically similar cells were found in the cerebrospinal fluid and bone marrow. Immunoelectrophoresis revealed lambda light chains in the pleural fluid and cerebrospinal fluid, as well as in the serum and urine. Clinically apparent pleural involvement and meningeal involvement by myeloma are each rare events. This is believed to be the first report of both phenomena occurring simultaneously and the first known case of light chain myeloma involving the cerebrospinal fluid.

Aged↗
PubMed1985

The bone marrow in AIDS. A histologic, hematologic, and microbiologic study.

During one year, 55 bone marrow biopsies from 49 patients with CDC-defined acquired immune deficiency syndrome (AIDS) were studied. Eighty-three percent were normocellular or hypercellular; 17% were hypocellular. Marrow plasma cells were increased in 83% of patients, most showing polyclonal hypergammaglobulinemia. Forty percent of patients showed peripheral neutropenia, 29% thrombocytopenia, and 79% lymphopenia with markedly reduced T4+ lymphocytes. Eighty-five percent of patients were anemic, with iron studies showing a pattern consistent with the anemia of chronic disease. Mycobacterium avium-intracellulare (MAI) grew from ten (20%) biopsies, four with granuloma and six without granuloma (five of these six also showed marrow hypocellularity). Small poorly formed granuloma (70-150 micron) were seen in eight (16%) patients (four AFB-culture positive, 4 negative). Three of four granuloma-positive, culture-negative cases eventually grew MAI from autopsy material. Five (10%) patients had lymphoplasmacytic aggregates; later, one developed lymphoma, another, markedly atypical lymphoid hyperplasia. Two additional patients showed marrow B-cell lymphomas. Of these findings, only marrow MAI meets the CDC definition of AIDS. However, in this series, small ill-defined granulomas, lymphoplasmacytic aggregates, and B-cell lymphomas also were found. The authors conclude that these latter findings, when seen in high-risk patients, particularly those with lymphopenia, anemia, and/or hypergammaglobulinemia, also strongly suggest the diagnosis of AIDS.

Acquired Immunodeficiency Syndrome↗