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Biomedical subjects

A Diego

Publications and source records attributed to A Diego.

13 recordsLinked to original sources
PubMed2005

Synthesis of three marine natural sesterterpenolides from methyl isoanticopalate. First enantioselective synthesis of luffolide.

[Reaction: see text]. The synthesis of three marine sponge metabolites, luffolide (4), 5, and 6, are described for the first time, establishing the absolute configuration of these compounds. The key intermediate, aldehyde 17, was obtained from methyl isoanticopalate, 11. The addition of 3-furyllithium to 17 and subsequent photochemical oxidation give the gamma-hydroxybutenolide 5 and its epimer at C-16. Sesterterpenolide 6 is obtained by dehydration of 5. From the key aldehyde 17, luffolide (4) was obtained in six steps.

Aldehydes↗
PubMed2005

Acute cyanide poisoning by subcutaneous injection.

A 30 year old woman with a history of depression and previous suicide attempts was brought to the emergency department in coma. She had injected herself with cyanide subcutaneously and had severe metabolic acidosis. She underwent sustained haemodialysis in the intensive care unit (ICU) before laboratory confirmation of cyanide poisoning. The serum cyanide concentration was 4.6 microg/ml. After 48 hours the patient, now asymptomatic, was discharged from the ICU.

Acute Disease↗
PubMed2000

Evaluation by explicit criteria of the use of total hip joint replacement.

OBJECTIVE: To evaluate the appropriateness of the use of total hip replacement (THR) using explicit criteria developed by an expert panel. METHODS: Patients with a diagnosis of osteoarthritis who were undergoing THR in five public hospitals in Spain were included consecutively in the study during a 1-yr period. The appropriateness of the indication was judged by explicit criteria developed using a mutidisciplinary approach. Complications were measured 3 months after surgery. One year after discharge, pain, functional limitation and general health were measured. RESULTS: After evaluation of 583 patients, 82 (13.6%) were considered to have undergone inappropriate procedures, and for 279 (46.2%) patients indication for the procedure was considered uncertain. Differences were found in the rate of appropriateness among some centres. One year after discharge, the perception of general health was slightly better in those patients who had been judged to have undergone an appropriate procedure. CONCLUSIONS: The study identified a moderate percentage of inappropriately performed THR. When considered together with those cases that were judged to have uncertain indications, the results indicate that further studies should be done to identify patients who may have an inadequate benefit:risk ratio from this procedure.

Aged↗
PubMed1998

Isolated retrovesical and extrarenal retroperitoneal hydatidosis: clinical study of 10 cases and literature review.

PURPOSE: Isolated extrarenal retroperitoneal echinococcal cyst is a rare manifestation of hydatid disease. We review the clinical findings of a series of isolated retrovesical and retroperitoneal hydatid cysts in an endemic area, with special emphasis on diagnostic pitfalls. MATERIALS AND METHODS: A retrospective 15-year review in a rural area of central Spain (600,000 population), with a global incidence of hydatidosis of 10 new cases per 100,000 population per year, revealed 10 patients (0.1 cases per 100,000 per year) with surgically treated primary extrarenal retroperitoneal echinococcosis and absence of other hydatid cysts in any organ. Clinical, radiological and laboratory data are analyzed. The literature of the last 15 years on hydatid disease with a primary retroperitoneal and retrovesical location is reviewed. RESULTS: A total of 42 cases of isolated retrovesical (25) and retroperitoneal (17) hydatidosis was compiled. Male predominance of 2.5:1 was noted and age ranged from 8 to 79 years (mean 42.2 +/- 5.4). The most frequent presentation was a palpable mass in 29% of the cases followed by flank pain in 24%, frequency in 17% and urinary retention in 14% of the cases. Hydatiduria of the urinary tract was present in 9.5% of the cases. Different serological investigations were performed in 45% of the cases with positive results in 68%. The lesion had been surgically removed in all cases. Therapy and followup of each patient were analyzed. CONCLUSIONS: An isolated retrovesical, retroperitoneal or even retrocrural cyst can be the unique manifestation of hydatid disease. Although difficult, preoperative diagnosis is desirable for the selection of a surgical approach and prevention of allergic reactions and operative spillage. A diagnostic algorithm and several therapeutic guidelines are proposed.

Adolescent↗
PubMed1997

Renal echinococcosis: clinical study of 34 cases.

PURPOSE: Hydatid disease, a cyclo-zoonotic parasitic infestation caused by the larval stage of the cestode Echinococcus granulosus, is prevalent worldwide. We reviewed the clinical findings of a large series of renal hydatidosis treated in an endemic area with special emphasis on diagnostic pitfalls. MATERIALS AND METHODS: A retrospective 15-year review in a rural area of central Spain (600,000 population), with a global incidence of hydatidosis of 10 new cases per 100,000 population per year, revealed 34 with renal echinococcosis treated surgically (3 to 4% of officially confirmed cases of hydatidosis). Clinical, radiological and laboratory data were analyzed. RESULTS: Renal hydatid disease mimicked other diseases. The combination of clinical history, imaging studies, and serological and urine investigation yielded a reliable pretreatment diagnosis in only 50% of cases and a presumptive diagnosis in 71%. Among imaging studies computerized tomography was the most valuable diagnostic examination. Moderate eosinophilia was found in half of the cases, while a third had scoleces in the urine. A diagnostic and therapeutic algorithm is presented. CONCLUSIONS: Preoperative diagnosis of renal hydatid disease is difficult even in an endemic zone. Imaging studies are suggestive but usually inconclusive, and the differential diagnosis with a renal tumor or complicated cyst may not be made without surgery. Renal sparing surgery is possible in a significant proportion of cases, particularly when preoperative diagnosis has been considered. Significant surgical morbidity can be expected, and the risk of anaphylaxis and hydatid seeding, although low, should not be overlooked.

Adolescent↗
PubMed1992

Effect of cell culture on rabbit colonic smooth muscle bradykinin receptors.

The aim of this study was to assess the effect of cell culture on the bradykinin receptor of rabbit colon myocytes. In longitudinal muscle strips prepared from distal colon, bradykinin stimulated dose-dependent contraction that was 62% of the maximal response to bethanecol. At 4 degrees C, [3H]bradykinin binding to fresh muscle homogenates from the distal colon was time dependent, saturable, and linearly related to tissue concentration. Specific binding of 0.6 nmol/L [3H]bradykinin was 80% +/- 2% of total binding. In competitive binding studies, Hill coefficients approached unity, suggesting the presence of a single class of receptors. The order of potency was bradykinin greater than [D-Phe7]bradykinin much greater than des-Arg9, [Leu8]bradykinin, which is consistent with results of a B2 receptor subclass. Colon myocytes from the longitudinal muscle layer achieved confluence and were harvested for studies after 12-14 days in culture. Bradykinin receptors were of high affinity [disassociation constant (Kd) = 672 pmol/L] and numbered 10,217 +/- 2567/cell. To show that the receptors on cultured myocytes were functional, the effect of bradykinin was measured (a) on intracellular calcium concentration using Fura 2 and (b) on prostaglandin E2 concentration in the culture media using radioimmunoassay. In cells grown to confluence on cover slips and preloaded with Fura 2, bradykinin stimulated the threshold response at 1 nmol/L and maximal response (increased intracellular calcium concentration from 229 to 633 nmol/L) at 1 mumol/L. Bradykinin, 100 nmol/L, increased Prostaglandin E2 in the culture media threefold. In summary, colon myocytes express functioning bradykinin receptors, which, unlike muscarinic receptors, persist in culture. Bradykinin appears to be a suitable agonist for studies of receptor-mediated intracellular events in cultured colon myocytes.

Animals↗
PubMed1992

[Carcinoma of the penis. Our experience with 22 cases].

The penis carcinoma is a neoplasia representing 0.7% of all male neoplasias, with an annual incidence between 1 and 2 cases per 100,000 inhabitants/year. The present study compiles the authors' experience in treating 22 patients presenting this neoplasia in the period between 1977-90. The procedures carried out included local resection, partial amputation, radical penectomy with lymphadenectomy plus radiotherapy, and palliative surgery plus radiotherapy all based on staging made following TNM grading. Therapy complications, follow-up, and survival results are explained. There were 5 occasions of spinocellular carcinoma co-existing with other neoplasias: 1 colon adenocarcinoma, 1 prostate carcinoma, 1 cleaved small cell centrocytic diffuse lymphoma, and 2 skin epithelioma in other sites, and relevant literature was reviewed. A background of psoriasis treated with psoralens plus UV was present in 4 cases, and caution was advised towards genital protection in patients undergoing UV radiations whether for therapeutic, recreational or cosmetic reasons.

Adult↗
PubMed1991

Genuine hereditary hydronephrosis in a three-generation family. Clinicopathological and genetic implications with a review of the literature.

The clinical features and management of genuine hereditary hydronephrosis (GHH) in 4 members of the same family are presented. Genealogical studies provide evidence of a dominant autosomal inheritance with complete penetrance. All affected members of the family had inherited the same HLA haplotype through the male line. This finding, added to those from previous association studies with histocompatibility typing (in 3 families), lends support to the localization of the GHH gene/s in the 6p human chromosome. Based on our findings from the present familial study and on a review of the literature, we suggest that all first-degree relatives of children or adults with genuine hydronephrosis should be screened by ultrasound. Such a prospective screening, including fetal echography, will lead to earlier diagnosis and treatment of asymptomatic cases and, moreover, will identify GHH cases for possible genetic counseling with regard to the empiric recurrence risk.

Adult↗
PubMed1990

[Xanthogranulomatous pyelonephritis. Retrospective study].

The incidence of PGX in our setting is low (0.67%). Middle-aged women comprise most of our cases. This disease process is usually unilateral; 53.2% of the present series had right-sided renal involvement. Over the past 17 years, 135 cases of histopathologically-documented XGP have been recorded at our hospital. Sixty-three cases were studied retrospectively. Patient history, symptoms and signs, and data gleaned from physical examination are presented. Similarly, patient outstanding pathogenetic features are described. Preoperative diagnosis of XGP is difficult. The availability of high resolution imaging techniques has enhanced diagnostic accuracy. Urinary cytology permits preoperative diagnosis with an accuracy rate of 80%. The postoperative prognosis is excellent.

Aged↗
PubMed1990

Antroduodenal manometry in the evaluation of chronic functional gastrointestinal symptoms.

Intraluminal pressure in the gastric antrum and duodenum was studied in 44 children and adolescents referred for evaluation because of functional symptoms, including vomiting, abdominal distension, and abdominal pain. Manometric abnormalities were found in 39 patients (89%). Abnormalities during fasting included absence of the migrating motor complex; retrograde, phase 3-like episodes; increased frequency, decreased duration, and decreased amplitude of phase 3 episodes; tonic duodenal contractions; nonpropagated bursts of duodenal contractions; and consistently low-amplitude or absent contractions. Postprandial abnormalities included a phase 1-like pattern (postprandial hypomotility) and phase 3-like episodes (failure to induce a fed pattern). The presence or absence of the migrating motor complex was a predictor of disability. Parenteral alimentation was needed by only 4 of 28 patients with the migrating motor complex, but by 13 of 16 patients without the migrating motor complex (P less than .001). In 15 of 18 patients studied on consecutive days, oral cisapride was associated with increases in the number and amplitude of duodenal contractions after a complex-liquid meal (P less than .02). It is concluded that antroduodenal manometry is a useful technique that elucidates the underlying gastrointestinal motility disorder present in the majority of children and adolescents with severe functional symptoms.

Adolescent↗
PubMedDate not supplied

[Uncoordinated urination syndrome].

Fourteen male and female patients aged 8 to 21 (mean 12.57 years) underwent clinical and urodynamic evaluation. These patients had different lower urinary tract symptoms, and flow changes and increased perineal muscle activity during voiding were demonstrated urodynamically. The urodynamic work up consisted of flowmetry, cystomanometry, detrusor pressure-flow test, videocystourethrography and electromyography of the periurethral sphincter. The urinary symptoms were nocturnal enuresis in 6 cases (42.85%), urinary infection in 6 (42.85%), difficulty in voiding in 4 (28.57%), urgency incontinence in 4 (28.57%), voiding urgency in 2 (14.28%) and diurnal urgency and frequency in 1 case (7.18%). The following 3 voiding bladder behaviour patterns were observed; 1) involuntary micturition from bladder instability (7 cases, 50%), 2) micturition from voluntary bladder contraction (2 cases, 14.28%) and 3) absence of bladder contractile activity with voiding achieved using the abdominal muscles (5 cases, 35.71%). Decompensated voiding was observed in 21% of the overall group. Of these, 75% belonged to the group that used the abdominal muscles to void. Dilatation of the proximal or prostatic urethra was frequently accompanied by bladder instability (57%). The urodynamic data may be useful in determining the outcome of treatment.

Abdominal Muscles↗