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Biomedical subjects

A Conde

Publications and source records attributed to A Conde.

At least 19 recordsLinked to original sources
PubMed2006

The diagnostic usefulness of AUDIT and AUDIT-C for detecting hazardous drinkers in the elderly.

We compare the diagnostic usefulness of the Alcohol Use Disorders Identification Test (AUDIT) and the AUDIT alcohol consumption questions (AUDIT-C) for detecting hazardous drinkers between the populations over and less than 65 years in primary care settings. To assess weekly alcohol intake an interview on quantity-frequency was administered to 602 patients. Hazardous drinking was defined as a level of consumption of 280 g of alcohol per week for men and 168 g for women. The participants received AUDIT, AUDIT-C and CAGE questionnaires. Gamma-glutamyltransferase (GGT), mean corpuscular volume (MCV), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) values were also determined. Average weekly alcohol intake among the population aged 65 and older was 83 g, and 10% were hazardous drinkers. In this age group, the sensitivities of AUDIT and AUDIT-C for detecting this type of drinkers were 67% and 100%, whereas specificities were 95% and 81% respectively. In the younger patient group, the sensitivities were 84% and 100% and the specificities 95% and 79% respectively. In conclusion, both AUDIT and AUDIT-C perform well at detecting hazardous drinkers in the group older than 65 years and that their sensitivities and specificities are comparable to those in younger ages.

Adult↗
PubMed2005

Diagnostic usefulness of brief versions of Alcohol Use Disorders Identification Test (AUDIT) for detecting hazardous drinkers in primary care settings.

OBJECTIVE: The aim of this study was to evaluate the diagnostic usefulness of the brief versions of the Alcohol Use Disorders Identification Test (AUDIT) for detecting hazardous drinkers and to compare it with that of the full-AUDIT in primary care settings. METHOD: Five hundred patients were randomly selected in a primary care center. An interview on quantity-frequency was administered for assessment of weekly alcohol intake. The standard used for classification of hazardous drinkers was a weekly alcohol consumption of 280 g for men and 168 g for women. Cut-off points were 8 for the full-AUDIT, 1 for the AUDIT-3 (third item), 3 for the AUDIT-C (items 1, 2 and 3), 5 for the AUDIT-PC (items 1, 2, 4, 5 and 10) and 3 for the modified Fast Alcohol Screening Test (m-FAST; items 3, 5, 8 and 10). Sensitivity, specificity, positive and negative predictive values, and areas under the receiver operating characteristic (AUROC) curves were measured. RESULTS: Diagnostic usefulness of the questionnaires for detecting hazardous drinkers was for the full- AUDIT: 81.4% sensitivity, 94.6% specificity and 0.97 AUROC curve; for the AUDIT-3: 83.1% sensitivity, 90.9% specificity and 0.89 AUROC curve; for the AUDIT-C: 100% sensitivity, 79.4% specificity and 0.97 AUROC curve; for the AUDIT-PC: 98.3% sensitivity 90.9% specificity and 0.97 AUROC curve; and for the m-FAST: 79.7% sensitivity, 93.7% specificity and 0.93 AUROC curve. CONCLUSIONS: The AUDIT-C and AUDIT-PC show a higher sensitivity, lower specificity and a similar AUROC curve than the full-AUDIT, thus allowing their use as screening instruments that are as reliable as the original test for detecting hazardous drinkers. The AUDIT-3 and m-FAST, when compared with the full-AUDIT, performed less well, therefore limiting their use for this purpose.

Adult↗
PubMed2001

The posterior interosseous flap: a review of 81 clinical cases and 100 anatomical dissections--assessment of its indications in reconstruction of hand defects.

Based on our experience of 100 cadaveric dissections and a series of 81 clinical cases, we have assessed the indications for the posterior interosseous flap in reconstruction of the hand. Large fasciocutaneous island flaps can be harvested, even when the radial or ulnar pedicles are damaged, sacrificing only vessels of secondary importance to the perfusion of the hand. Compound flaps can be dissected based on muscular, musculoperiosteal and fascioperiosteal branches. The primary indications for using this flap are dorsal hand defects up to the metacarpal joints, reconstruction of the first web space up to the interphalangeal joint of the thumb and extensive lesions on the ulnar border of the hand.

Adolescent↗
PubMed1999

The reverse auricular flap: a new flap for nose reconstruction.

In the present article, the authors describe a new chondrocutaneous island flap from the ear helix for nose reconstruction. Anatomic studies showed that helix vascularization depends mainly on the superficial temporal vessels. The presence of vascular communications between the anterior frontal branch of the superficial temporal system and the supraorbital and supratrochlear arterial systems allows this flap to be used in a reverse vascular flow fashion. This new flap has been used successfully in seven cases for reconstructing composite defects of the nasal tip and ala. The donor-site defect is repaired with an advancement and rotation flap from the helical rim, leaving an inconspicuous scar and giving an acceptable cosmetic result of the donor area.

Adult↗
PubMed1999

[Dorsal metacarpal flap with an extensive retrograde pedicle. Anatomic study and 22 clinical cases].

The dorsal digitometacarpal flap or extended distal pedicled dorsal metacarpal flap is a new skin flap, useful in reconstructing large distal defects on the dorsal aspect of the digits. It is raised on the dorsum of the hand, over an intermetacarpal space. Its vascularisation is provided by proximal dorsal cutaneous branches of the digital collateral arteries through the rich, anastomotic arterial network of the webspace. This flap is a useful flap compared to others flaps harvested from the dorsum of the hand, such as the reverse metacarpal flaps. The operative procedure preserves the dorsal interosseous muscles aponeurosis, the junctura tendinum and the dorsal metacarpal artery. Its vascularisation depends on the webspace arterial network; it is constant contrary to the dorsal metacarpal arteries of the ulnar spaces. This flap is indicated to cover distal defects on the dorsum of the digits because of its large rotation arc. The anatomical basis and operative technique of the flap are described. Two out of 22 clinical cases were selected to illustrate the ability of this flap for reconstruction of digital defects.

Adult↗
PubMed1999

[The reverse auricular flap. A new flap].

The authors describe a new chondrocutaneous reverse island flap from the ear helix for nose and eyelid reconstruction. Anatomic studies showed that the blood supply of the helix is derived from the superficial temporal system. The presence of vascular communications between the anterior frontal branch of the superficial temporal artery and the supra-orbital and supra-trochlear arterial systems allows this flap to be used in a reverse vascular flow fashion. Three flaps have been successfully used for reconstruction of alar and nose tip defects and in one case for total lower eyelid reconstruction. The donor site is repaired with an advancement and rotation flap from the helical rim giving an acceptable result. In this paper, the authors propose a new pedicle flap for reconstruction of complex nose and eyelid defects.

Adult↗
PubMed1998

Hypothenar hammer syndrome: management of distal embolization by intra-arterial fibrinolytics.

We report a case of hypothenar hammer syndrome. The ulnar artery aneurysm was resected and a complete thrombectomy of the superficial palmar arch, the common digital and the proximal part of the collateral digital arteries was carried out. The arterial defect of the ulnar artery was repaired by a vein graft. Post-operatively, no clinical improvement was observed on the vascularisation of the second and third fingers. The arteriogram confirmed the presence of arterial obstruction on the distal part of the digital collateral arteries of this two fingers. The finger pulp started to show areas of skin gangrene and in view of the risk of finger necrosis, we decided to use fibrinolytics. This embolic events was dissolved by continuous fibrinolytic and anticoagulant intra-arterial infusion. The treatment was maintained for ten days restoring a normal digital vascularisation.

Adult↗
PubMed1998

[Microsurgical reconstruction of the head and neck: experience of 63 free flaps].

The authors present the experience of 63 clinical cases of microsurgical reconstruction of the head and neck. These reconstructions were accomplished by different microvascular free flaps which were selected according to the type, size and location of the defects. Fasciocutaneous, osteofasciocutaneous, adipofascial, myo, myocutaneous, myosseous, jejunum and great omentum flaps were applied. The etiology was traumatic in 10 cases, tumoral in 41 cases, congenital in 7 cases, iatrogenic in 3 cases and infectious in 2 cases. The reconstructed anatomical regions were the scalp in 6 cases, the skull base in 1 case, the orbit in 3 cases, the nose in 1 case, the hemiface in 7 cases, the lips in 1 case, the intraoral cavity in 21 cases, the mandible in 8 cases, the intraoral cavity plus mandible in 11 cases and the cervical esophagus in 1 cases. An analysis was made of surgical times, selection and survival rate of the free flaps and the morphofunctional quality of the reconstructions. Considering the good quality of reconstructions, the amelioration of quality of life and the low morbidity in these patients, microvascular free flaps are considered a first choice technique for head and neck reconstruction when the size and location of the defect prevents the use of local flaps.

Adult↗
PubMed1998

[Microsurgical reconstruction of the upper extremity. Experience with 24 free flaps].

The authors present the experience of 24 clinical cases of microsurgical reconstruction of the upper limb. These reconstructions were accomplished by different microvascular free flaps which were selected according to the type, size and location of the defects, having applied fasciocutaneous, adipofascial, myo, myocutaneous, tendofasciocutaneous, omentum flaps and 2nd toe transfers. The etiology was traumatic in 23 cases and tumoral in 1 case. A careful analysis was made for surgical times, selection and survival rate of the free flaps and the morphofunctional quality of the reconstructions. Microvascular free flaps are considered the choice technique for upper limb reconstruction, particularly for the hand in certain defects, considering the better anatomic and functional quality of the reconstructions.

Adolescent↗
PubMed1998

[Revascularization and reimplantation of the upper extremity. 15-year-experience with 114 cases].

Progress in micro or macro replantation has resulted in higher survival rates of formerly amputated parts. More amputated digits or limbs survive because the time of ischemia can be exceeded by using cold storage or perfusion. Homo or heterodigital vessel transposition, expanded indications for vein graft interposition, as well as heterotopic transplantation allow for extremity preservation even in crush injuries, and in disastrous multiple amputations combined with contusion or avulsion. Secondary reconstruction with regard to bone defects, tendon repair, and eventual nerve grafting have to be aspired, finally leading to an improvement of functional results in daily and leisure activities as well as in early professional readaptation. A total of 114 microvascular extremity replantations/revascularizations with a survival rate of 77.2% were followed for an average of 15 years.

Accidents, Occupational↗