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Biomedical subjects

A Conde

Publications and source records attributed to A Conde.

At least 37 records · Page 2Linked to original sources
PubMed1997

[Reconstruction of the anterior cranial base with a frontal muscle flap in cerebrospinal fluid fistulae].

Craniofacial infection is a major problem for the plastic and neurosurgical team. Previous successful experiences with free muscle and omentum flaps and the galea frontalis myofascial flap have been reported, avoiding disastrous complications after frontofacial advancements and the resection of skull base tumors. The authors report the clinical use of the galea frontalis myofascial flap in the treatment of anterior fossa CSF leaks. This flap provides an adequate sized and vascularized barrier between the cranial and nasal cavities through which the cells of the inflammatory response reach the target area. This technique was used in 11 cases with complete success; in-6 patients, repair of the anterior cranial base bone defect was performed with split calvarium bone grafts, harvested from craniotomy bone. In all the patients, neither the recurrence of the CSF leakage nor post-operative meningitis or its recurrence were observed.

Adult↗
PubMed1995

Peripheral blood T lymphocytes in seasonal bronchial asthma.

Variations in T lymphocytes in asthmatic patients are related to disease severity. However, the effects of natural exposure to pollens on peripheral blood T lymphocytes have not been clarified. In this paper, the effects on peripheral blood CD4 and CD8 lymphocytes from pollen-sensitive subjects and from nonatopic donors were studied during and outside the pollen season. In patients who suffer from seasonal asthma, we found an increase in the CD4/CD8 bright ratio and a decrease in the mean number of CD4 receptors per cell during the pollen season. No variation was observed in healthy subjects. These results suggest that CD4 lymphocytes may be causally linked to the pathogenesis of seasonal bronchial asthma.

Adolescent↗
PubMed1995

[Cardiac tamponade with the absence of a paradoxical pulse. The practical utility of echocardiography].

A patient with cardiac tamponade but without hypotension and pulsus paradoxus is reported. In this patient, echocardiography confirmed the diagnosis of cardiac tamponade, showing diastolic collapse of the right ventricle and also the presence of an atrial septal defect (ostium secundum) that explains the absence of pulsus paradoxus. The role of echocardiography in those rare clinical situations that in the presence of cardiac tamponade showed no pulsus paradoxus are discussed.

Cardiac Tamponade↗
PubMed1992

[Echocardiography with intravenous dipyridamole infusion in the assessment of ischemic cardiopathy. A comparison with the stress test].

BACKGROUND: Diagnosis of ischemic cardiomyopathy by noninvasive methods is a challenge for the clinician. Echocardiography with intravenous administration of dipyridamole has been proposed as an alternative to exercise stress test in this setting. METHODS: Intravenous administration of dipyridamole (0.84 mg/kg in 6 minutes) with two-dimensional echocardiography and 12-lead electrocardiographic monitoring was performed in 50 patients. The test was considered positive when contractility of any of the left ventricular segments decreased, at least, one grade. In that moment, dipyridamole administration was stopped and aminophylline (40-240 mg over 1 to 3 minutes) was given. All patients underwent exercise stress test and coronary angiography. RESULTS: Significant coronary artery disease (70% stenosis in, at least, one of the major vessels) was demonstrated in 32 patients. Twenty of these had a positive dipyridamole echocardiography test (62%) and 23 had a positive exercise stress test (71%). None of the patients without significant coronary artery disease had a positive dipyridamole echocardiography test and 5 patients (23%) has a positive exercise stress test. Dipyridamole echocardiography test had and overall sensitivity of 60% and a specificity of 100%. Exercise stress test had an overall sensitivity of 75% (NS) and a specificity of 67% (p less than 0.01). Dipyridamole echocardiography test was well tolerated: there were no complications during the test. One patient had a transitory type I second-degree AV block. CONCLUSIONS: Dipyridamole echocardiography is a high specificity test for coronary artery disease and has a similar sensitivity than exercise stress test. It is well tolerated and in the authors' experience there were no complications.

Adult↗
PubMed1992

Relative and combined roles of ethanol and protein malnutrition on skeletal muscle.

The aim of the present study is to analyse the relative and combined effect of ethanol and protein malnutrition on muscle changes in ethanol-fed rats. The study was performed in 32 animals divided into four groups, fed with the Lieber-DeCarli control, 36% ethanol, 2% protein, and 36% ethanol/2% protein-containing diets, respectively. Right gastrocnemius muscle was removed two months later, and histochemical-morphometrically studied. Type IIb fibre atrophy was observed both in the alcoholic and protein-deficient animals. The combination of these factors led to a slightly more marked atrophy. Malnutrition led to a decrease in type I fibre diameter; ethanol caused an increase in their size; whereas concurrent administration of ethanol and a protein deficient diet led to type I fibre atrophy. The proportion of type IIb fibre decreased in the three experimental groups with respect to the control group, especially in the alcoholic, protein-deficient animals. Thus, malnutrition potentiates the effect of ethanol except for changes in type I fibre diameter, in which the effects are opposite.

Animals↗
PubMed1991

Splenic hydatidosis.

This report is concerned with ten patients treated surgically for a splenic hydatidosis. Splenic echinococcosis represents 3.5% of abdominal hydatid cysts treated in our Service. When splenic hydatidosis was diagnosed, the spleen was the first and only localization of hydatid disease in three cases. One of these patients underwent surgery for a pulmonary cyst four years later. Splenic cysts were asymptomatic in six patients. The most frequent clinical sign of splenic hydatidosis was a painful mass in the left upper abdominal quadrant. Ultrasonography and axial computed tomography (axial C.T.) were the most useful diagnostic tools. The complications arising from splenic hydatidic cysts were infection, rupture in the abdominal cavity and fistulization to the colon. A splenectomy was performed in every case. There was no mortality and morbidity was principally related to the hepatic-associated hydatidosis. It is concluded that splenic involvement is a rare manifestation of hydatid disease but should be looked for in a systematic way in patients with this diagnosis.

Adult↗
PubMed1989

[Hemorrhagic recurrence after operations of azygoportal disconnection].

One of the main drawbacks attributed to azygoportal disconnection operations in the surgical treatment of bleeding esophageal varices is recurrence of hemorrhage. The present paper reviews the results obtained as regards hemorrhage recurrence in 4,975 patients who underwent azygoportal disconnection in 41 series published in the western literature in recent years. An analysis is also made of the factors that, according to different authors, could be related to the failure of these procedures to prevent eventual variceal hemorrhage.

Azygos Vein↗
PubMed1988

[Profile and course of cardiovascular morbidity and mortality in Conakry. Apropos of 268 cases seen at the Cardiology Department of the Ignace-Deen University Hospital 1986-1987].

Over a period of two years (1986-1987), the authors have studied the morbidity and mortality of various cardiovascular diseases in a hospital population of 268 patients. By comparing it with a previous similar study conducted over 5 years (1981-1985), they have reached the following conclusions: the prevalence of the main nosological groups is equivalent (H.B.P., rheumatoid valvulopathies, chronic pulmonary heart, ischemic cardiopathies; severity of the valvulopathies and their prognosis which raise social and medical problems especially that of cardiac surgery, still inexistent in Guinea; increased prevalence of diseases such as hypertension and rheumatoid valvulopathies. They suggest early screening, especially for rheumatoid valvulopathies and hypertension, which cause major social problems because of their complications. Besides, it would be desirable that visits at regular intervals be made mandatory in schools and universities and at preemployment examinations and in all SMI (?) centers in the country.

Adolescent↗
PubMed1988

[Etiologic and nosologic considerations apropos of 574 cases of cardiac decompensation in Conakry].

The authors analyze 574 cases of heart failure observed in the Cardiology Department of the University Hospital Ignace-Deen in Conakry, in a period of 5 years (1981-1985), from the etiological and nosological standpoints. The result is that cardiac insufficiency is very frequent in the department and the patients, in most cases, are found in stage IV of the NYHA (64.98%). There are more men (59.75%) than women (40.25%). Age varies from 15 to 80 years (mean: 49.2 years). Hypertension (37.47%), senile cardiopathies (20.20%), various myocardiopathies (17.24%), rheumatoid valvulopathies (13.95%) are the most frequently encountered etiologies. Pericarditis is rare (0.34%).

Adolescent↗
PubMed1988

[Valvular cardiopathies in Conakry. Apropos of 182 hospitalized cases].

The cardiovascular pathology is dominated in Guinea, as in most third-world countries, by valve cardiopathies. These valve diseases are particularly severe and affect children and teen-agers, representing a real public health problem. The severity of these cardiopathies is also obvious because of the severe haemodynamic repercussions and the palliative nature of the medical treatment, since most of these patients are in need of a valve replacement procedure, which currently is only available to some of them. Thus, everything must be done to prevent and treat these diseases. The present study, carried out in a hospital environment, concerns 182 cases of valve cardiopathies hospitalized in the Cardiology Department of the University Hospital Ignace-Deen between January 1, 1981 and December 31, 1987.

Adolescent↗
PubMed1988

[Myocardial infarction in Conakry. Apropos of 11 cases with 4 coronarographies].

The authors study 11 cases of myocardial infarction, hospitalized in the Cardiology Department of the University Hospital Ignace Deen in Conakry, between 1981 and 1987 inclusively, in a total of 842 patients. The series includes 9 men and 2 women, with ages varying from 40 to 63 years, mean 52.4 years. From this study, it results that the frequency of myocardial infarction reaches 1.28 p. cent. From the epidemiological standpoint, the patients belong to relatively well-to-do socio-economic strata. The coronary disease in these areas is original in that it is infrequent. However, the risks factors are the same as elsewhere: hypercholesterolemia: 8 in 11 cases, obesity: 7 in 11 cases; and tobacco abuse: 5 in 11 cases.

Adult↗
PubMedDate not supplied

Chronic alcoholic myopathy and nutritional status.

To investigate the prevalence of alcoholic myopathy and its relationship to the nutritional status, we performed a muscle biopsy on the vastum lateralis of 60 consecutive hospitalized alcoholic patients using a Tru-Cut needle, processing it for light microscope and ultrastructural analysis. The nutritional status was assessed by anthropometric measurements such as midarm circumference, triceps skinfold and midarm muscle area, and serum albumin. The hallmark of chronic alcoholic myopathy, fiber muscle atrophy, was present in 33% of the patients, necrosis scarcely being observed (1.5%). Ultrastructural alterations as lipid and glycogen accumulation or mitochondrial and myofibrillar alterations were nonspecific and observed in nearly all the cases where atrophy was present. Malnutrition was frequent in our patients: 39% and 34% showed a triceps skinfold and a midarm muscle area, respectively, under the fifth populational percentile. Patients with muscle fiber atrophy or ultrastructural changes showed a worse nutritional status, not only regarding muscle protein (assessed by midarm muscle area or creatininuria and explained by fiber atrophy), but also regarding fat stores assessed by triceps skinfold. Toxic effect of ethanol and malnutrition may act synergistically leading to chronic alcoholic myopathy.

Adult↗
PubMedDate not supplied

The heroin epidemic in New York City: current status and prognoses.

Since 1989, heroin production worldwide has risen; in New York City, as its purity rose and prices fell, street-level markets were restructured and offered heroin in addition to cocaine and crack (which had been popular during the 1980s). While officials estimate that there are between 500,000 and one million hard-core, chronic heroin users nationwide, evidence of supplemental users heralding another heroin era includes: more overdoses and overdose deaths, greater demand for treatment, larger seizures of heroin at all levels of distribution and related arrests, and broader media coverage. In this article, the authors describe the characteristics of populations in which there may have been a percentage increase of new users, such as young middle- or upper-class European-Americans, young Puerto Ricans and recent Haitian and Russian immigrants. The abstinence of young African-Americans is also noted. The article ends with a preliminary needs assessment of the new users in the areas of health (including AIDS), housing, employment, treatment, arrest and imprisonment.

Administration, Inhalation↗
PubMedDate not supplied

Diagnostic usefulness of carbohydrate-deficient transferrin for detecting alcohol-related problems in hospitalized patients.

We evaluated the diagnostic usefulness of carbohydrate-deficient transferrin (CDT) for detecting alcohol-related problems (ARP) in hospitalized patients, assessed potential differences according to gender and age, and compared this value to the other screening measures conventionally used, namely the CAGE questionnaire and standard biological markers MCV (mean corpuscular volume) and GGT (gamma-glutamyltransferase). CDT sensitivity for detecting ARP was 70%, specificity 75% and area under the receiver operating characteristic curve 0.76%. Its sensitivity was shown to be lower both in the female group (65 vs 71%) as well as in the younger-age group whereas its specificity was lower in the liver-damaged group (55%). CDT diagnostic value did not exceed that of CAGE (sensitivity 78% and specificity 99%), MCV (sensitivity and specificity 74%) or GGT (sensitivity 82% and specificity 53%) but was better than those of other biochemical measures. We conclude that CDT is an effective biological marker for the detection of ARP among hospitalized patients, but that its diagnostic usefulness does not exceed that of some other alternative measures commonly used.

Adult↗
PubMedDate not supplied

Phenotypes of alpha-1-antitrypsin in intrinsic asthma and ASA-triad patients.

The frequency of presence of various phenotypes of alpha 1-antitrypsin was studied in 31 patients with intrinsic asthma and 11 with ASA-Triad, and compared to a group of 200 people representative of the general population. The MZ and SZ phenotype is more frequent in intrinsic asthmatics (p < 0.00001) and MZ in ASA-Triad (p < 0.0005) than in the control group. No differences were found between the intrinsic asthmatics and ASA-Triad. All the patients were divided into groups according to their clinical characteristics and an increase of the MZ phenotype was observed (p < 0.001) in patients with: nasal polyposis, intolerance to non-steroidal anti-inflammatories, a family history of atopy and peripheral eosinophilia (p < 0.01). Alpha-1-antitrypsin deficiency could be important in the pathogenesis of inflammatory processes and in the clinical manifestations characteristic of patients with intrinsic asthma and ASA-Triad.

Adult↗