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A Crespo

Publications and source records attributed to A Crespo.

68 records · Page 4Linked to original sources
PubMedDate not supplied

[Diagnostic value of gated-SPECT for each coronary artery in patients clinically diagnosed of coronary heart disease].

UNLABELLED: This study aimed to evaluate the diagnostic value of gated-SPECT for each coronary artery in patients with clinical diagnosis or suspicion of coronary heart disease. PATIENTS AND METHODS: The study population is made up of 43 patients (64 9 years, 88% male gender) with prior clinical diagnosis or suspicion of coronary heart disease who had undergone gated-SPECT (99mTc-tetrofosmin) and cardiac catheterization. Scintigraphic study after exercise treadmill test and rest study were performed on the same day. RESULTS: Gated-SPECT showed perfusion defects in 86% of patients, the mean number of territories with perfusion defects being 1.58 +/- 0.79. A total of 39 (91%) of the 43 patients had significant coronary heart disease. Single, two- and three-vessel disease was demonstrated in 12 (28%), 15 (35%) and 12 (28%) patients, respectively. Sensitivity and specificity were 81% and 91%, respectively, for left anterior descending artery, 88% and 65% for right coronary artery, and 55% and 81% for circumflex one. CONCLUSIONS: Myocardial scintigraphy with gated-SPECT offers high sensitivity and specificity for the diagnosis of left anterior descending artery disease. However, sensitivity for circumflex artery and specificity for right coronary artery were low in our series.

Coronary Vessels↗
PubMedDate not supplied

[Clinical predictors of the presence of perfusion defects in more than than one territory in myocardial scintigraphy with GATED-SPECT].

BACKGROUND AND OBJECTIVE: Extension of perfusion defects is associated with outcome in patients undergoing myocardial scintigraphy. The study aimed to identify the clinical characteristics that can predict the existence of perfusion defects in more than one territory in patients referred for myocardial scintigraphy with GATED-SPECT. PATIENTS AND METHODS: A total of 193 patients undergoing myocardial scintigraphy with GATED-SPECT (99mTc-tetrofosmine) were studied. Clinical variables and scintigraphy results were studied to determine what clinical variables are associated with perfusion defects in more than one territory. RESULTS: The number of territories with perfusion defects per patient was 1.1 0.8 and 29% had perfusion defects in > 1 territory. Patients with greater probability of having perfusion defects in > 1 territory were those with previous myocardial infarction (44% vs 21%, p = 0.030) and males (33% vs 10%, p = 0.006). In addition, patients with > 2 coronary risk factors had a statistical tendency to have defects in > 1 territory (47% vs 20%, p = 0.057). Only 15% of the patients with one of these three characteristics had perfusion defects in > 1 territory in comparison with 45% and 83% in those with 2 or 3 factors, respectively. CONCLUSION: Considering 3 simple clinical characteristics (male gender, previous infarction and existence of > 2 coronary risk factors), it is possible to predict which patients are more likely to show perfusion defects in > 1 territory during GATED-SPECT myocardial scintigraphy.

Coronary Disease↗
PubMedDate not supplied

Nucleolar organizer region (NORs) in pseudocarcinomatous hyperplasia and squamous cell carcinoma of the oral mucosa.

Counts of nucleolar regions (NORs) demonstrated by a silver staining technique in paraffin sections, have been used to distinguish benign from malignant lesions. AgNORs were studied in 24 biopsies from oral cavity (5 cases of normal oral mucosa, 5 of pseudocarcinomatous hyperplasia and 14 of squamous cell carcinoma, subdivided according to degree of differentiation: 5 grade 1, 5 grade 2 and 4 grade 3) to find whether they were helpful in distinguishing pseudocarcinomatous hyperplasia due to chronic parasitic infections from squamous cell carcinoma. Two methods of counting AgNORs were used: (A) a simpler one which counts nucleolar clusters (AgNU) and satellite AgNORs and the other (B) counting all individual AgNORs, including those within AgNUs. In both methods the lowest mean values were observed for grade 3 carcinoma, while the highest belonged to grade 2 carcinoma. The simpler method (A) was the most useful because AgNU counts showed significant difference when pseudocarcinomatous hyperplasia was compared with grade 1 and 2 carcinomas, which are the most difficult to discriminate from it. However the overlapping of values render the technique of limited use in individual cases.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

MCA serum determination in breast carcinoma patients for the diagnosis of bone metastases.

Serum MCA levels were determined in 173 consecutive patients with breast cancer in order to assess the clinical utility of MCA for the detection of bone metastases. Bone pathology was diagnosed by scintigraphy, radiology and clinical follow-up. Metastases were found in 37 patients, benign lesions in 25, and in 111 no bone lesions were found. Eighteen of the 173 bone scans were considered indeterminate for metastases. Based on the receiver-operating characteristic curves (ROC) analysis, the cut-off level for MCA was set at 20 U/ml. Only in 4 of the 37 patients with bone metastases MCA was below 20 U/ml. All 4 patients had completed their chemotherapy course within six months before MCA determination. Only in 6 patients of the 136 without bone metastases MCA levels were above 20 U/ml. Of the 18 patients with indeterminate bone scans, 15 had benign lesions and all of them had MCA levels below 20 U/ml. MCA determination is a sensitive method for the detection of bone metastases in breast carcinoma. We encourage the use of this procedure for the selection of high-risk groups or as a complementary method for the interpretation of bone scintigraphy.

Adult↗
PubMedDate not supplied

[Electroencephalographic effects of subhypnotic doses of midazolam in healthy subjects and in brain disease patients].

The aim of this study was to analyze the electroencephalographic alterations produced by minimum doses of midazolam and look for a theoretic base for these changes in the benzodiazepinic receptor. To do so, the possible abnormal responses provoked by midazolam on the EEG of patients with ischemic cerebral infarctions were studied. Sub-hypnotic infusions of midazolam (0.15 mg kg/min) were administered prior to anesthetic induction in three groups of patients: control group, patients with tumoral cerebral pathology group, and ischemic cerebral infarctions group. In addition to the known modifications obtained in the patients of the control group, those presenting bioelectric activity alterations due to tumoral pathology did not show modifications. In the group of patients with ischemic infarctions, the intravenous perfusion of midazolam induced moderate increase in the localized theta and delta frequency and a lower representation of the beta rhythm which was also of lower amplitude. Midazolam is capable of making slow rhythms on the EEG, following it administration at low doses, in ischemic zones of the brain.

Adult↗