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Biomedical subjects

A M Alonso

Publications and source records attributed to A M Alonso.

13 recordsLinked to original sources
PubMed1997

Case report and review of the literature: primary twin ovarian pregnancy.

A case report of primary twin ovarian pregnancy is presented. A 36 year old woman, gravida 4 para 3, was admitted to the hospital for suspected ectopic pregnancy, with vaginal bleeding at 11 weeks after her last menstrual period, associated with pelvic pain. An endovaginal ultrasonography led to the diagnosis of twin ovarian right ectopic pregnancy with two dead fetuses associated with a compartmentalized haemoperitoneum. Unilateral oophorectomy was carried out by laparotomy. Histological studies confirmed an uni-ovular di-amniotic ovarian pregnancy. Seven cases of ovarian twin pregnancies are reviewed in the literature. This case is the first one where diagnosis has been made by endovaginal sonography.

Adult↗
PubMed1995

Repair of radiation-induced vesicovaginal fistula with a rectus abdominis myocutaneous flap.

The cutaneous RAM flap was used successfully to repair a radiation-induced vesicovaginal fistula. Patient selection is important, ideally one with a fatty lower abdominal wall and without a previous incision transecting the inferior rectus muscle below the umbilicus. The RAM flap has excellent vascularity, allows augmentation of the bladder, and permits an extraperitoneal approach, factors that are important when operating in an irradiated field.

Cystoscopy↗
PubMed1995

A computer system for epidemiological surveillance.

In epidemiological surveillance, it is imperative that any unusual increase in reported cases be detected as quickly as possible. In the surveillance unit at "Pedro Kourí," it was necessary to create a computer system for the surveillance of transmissible diseases in order to manage such variables as morbidity, mortality, and the circulation of causal agents. As usage flexibility is a fundamental requirement, we developed VIGILA as a system readily adaptable to any level of the country's health organizations (national, provincial, or municipal). VIGILA permits the storage, validation, and statistical analysis of morbidity and mortality data, and it also allows the user to apply these features to causal agent information. These manipulations are all performed in the context of a specific transmissible disease. The stored information can be displayed in different types of statistical formats, such as calculated rates, accumulates and medians. The user can also design his/her own tables for display. In addition, the program offers graphics that depict the endemic forecast for a specific region and age group. Reliable forecasts based on temporal models of an epidemiological indicator are necessary for the prediction of the non-epidemic indicator and for the elaboration of an alert threshold. The endemic forecast or endemic channel is calculated by means of a modified version of R. Serfling's model [1] which adapts to data series with stationary characteristics. In this case, the model is fixed for the medical attention protocol and the circulation of agents of a specific transmissible disease. The parameters of the model are estimated by the least square method. The confidence limits are calculated with the T-Student distribution [2]. To enter information about a specific disease and level of health concern, the user must define the disease under analysis, the principal territory under surveillance and its dependencies, the causal agents of the disease, and the frequency with which the disease is reported. This system stores the number of cases (morbidity) and death (mortality) that occurred in the territories and age groups defined during entry. To facilitate the calculation of morbidity and mortality rates, information pertaining to the number of territory habitants and their age groups is also stored. The laboratory data includes the number of analyzed samples in the territories and age groups defined in the data entry, and the samples that were positive to the defined agents. Among the principal uses of the system are: calculation of cumulative cases, rates, and cumulative rates for the specific period of analysis, territory, and age group; comparison of these health indicators with the previous year's indicators or with the median of the previous years' indicators' calculation of the endemic forecast that permits the user to observe the epidemiological situation by territories and age groups; and the early detection of an increase in disease occurrence. The system also offers a geographical representation of the epidemiological situation in the territories, showing a map with the evaluation of each territory with respect to four possible risk factors. VIGILA is available in both DOS and WINDOWS 3.1 formats. This system allows the evaluation of the situation at a specific point in time in the analyzed territories, and may alert the infection control team to an epidemic early enough to allow implementation of control measures.

Computer Systems↗
PubMed1981

[Sézary-Baccaredda syndrome].

One case of Sezary Syndrome is presented and studied from the clinical, histopathological and hematological point of view. Clinically the patient presented besides keratodermia on the palms and a severe pruritus, an erythrodermia of very ostensive redness, like the so-called Hallopeau's red man. On the skin, by histological examination, it was observed an infiltration with some round cells, whose nucleus were hyperchromatic and irregular, as it is to be seen in the Sezary's cells. A lymph node taken from the cervical region did not show any specific infiltrate but only a dermopathic adenopathy. Lymphoid cells of folded nucleus were revealed by the hemogram, quite suggestive of Sezary's lymphoma. In the marrow, the normal cells kept on their regular proportion, but some abnormal and invasive ones stand out with their convoluted nucleus, quite suggestive of Sezary's cells. These typical Sezary's cells have been found in the skin lesions, in the blood and in the marrow. The possible origin--in the skin or in the lymph nodes, but not in the marrow--of such cells is put to a summarized discussion. Finally, the Sezary's Syndrome may be an erythrodermic or leukemic variant of "morbus fungoide". Treatment on the basis of MOPP and CHOP methods with Bleomycin association has been attempted but, so far, the results have not been satisfactory in spite of an 18 month treatment.

Antineoplastic Agents↗
PubMed1981

[Albopapuloid epidermolysis bullosa (Pasini's disease)].

The aim for this communication is one case of the dystrophic Epidermolysis bullosa in its variant just called as "albopapuloid". The patient a male of 25 years, suffers from the disease since the age of 2. His mother and one brother show the same disease. The clinical manifestations began as bulloe on the superior and inferior limbs. The bullae heal with atrophic scars and the eruption is constantly relapsing after subsiding. Besides the bullous eruption there are other lesions persistently coming out as whitish elevations which are elongate as to form numerous streaks on the surface of the skin. Such lesions started at the age of 5 and do not come from the bullae but they are quite independent, and constitute the essential characteristic for the albopapuloid clinical variant. Small miliary epidermal cysts are seen over the scars. Dystrophic changes of the nails with absence of many of them and the toes show the lst phalanges partially absorbed. On histological examination the bullae are subepidermal and contain a fibrin-leukocytic exudate. The albopapuloid lesions reveal keratosis, epithelial atrophy, diffuse and condensed fibrosis in the corium and around the hair follicles.

Adult↗
PubMed1975

[Reactional status of leprosy].

Reactional leprosy is studied according to its clinical forms A) Lepromatous a) Acute lepromatization: encroaching and invasive nature; the patient becomes more and more lepromatous ; bad prognosis. b) Erythema nodosum: "contusiform dermatitis"; variable prognosis not so bad as it is in the preceding case; allergic nature and its evolution is usually detained and therapeutics efficient. c) Erythema multiform. d) Lucio's phenomenon: vascular lesions and consequently necrosis as a complication of the "erythema necrotisans" (beautiful leprosy). B) Tuberculoid Reactional tuberculoid is the only one in this benign type, the Mitsuda's test must always be positive and prognosis consequently good. C) Dimorphous or "Borderline" whose Mitsuda's test is mostly negative, sometimes positive, but not stable. The lesions may stimulate the tuberculoid leprids but they invade mucous membranes, are impregnated by pigmentation, may present the Unna's band, and other characteristics of the Lepromatous type. Are associated (fever, asthenia and emaciation). Prognosis not very good, because of the possibility of lepromatization, according to its tendency. Evolution slower and frequent relapses. Besides there are nodular lesions. Pathogeny 1) Perifocal allergic reaction (Jadassohn). Similar to epituberculosis and Herxheimer reaction. 2) Septicemia. Sensitized tissues inside or outside the lesions, are invaded by the bacilli and so the allergic reaction takes place. Even without culture resources, Mycobacterium leprae has been found in the blood by direct examination. 3) Autoimmunization (Waldenstrom, Matthews and Trantman, 1965). Based upon the similarity between both humoral syndromes, in leprosy reactions and collagenous, diseases, as to: hypergammaglobulins, hypercryoproteins, antigammaglobulins, serological reactions (Wassermann, Kahn, Kline, VDRL) positives, Antistreptolysin O, protein C reactive, antinuclear factors, latex and Wadler-Rose test positives (rheumatoid tests) lowering of complement. If leprosy reaction is like this, it should be the less agressive of the autoimmune diseases. a) Its eruptions are cyclic not of long standing duration, as a general rule. b) Its prognosis has been recognized as good, except lately, because of the use of corticoid therapy which has been fatal, in many cases. After some years the leprosy reaction cures spontaneously. Treatment (see article)

Erythema Multiforme↗
PubMedDate not supplied

[Effect of prosthesis type and size on the hemodynamic response of mitral valve prostheses to exertion].

BACKGROUND: Doppler echocardiography is current tool for hemodynamic evaluation of mitral prosthetic heart valves. It's accepted that the area and the gradients by Doppler echocardiography are not influenced at rest by valvular type and valvular size. We evaluated the influence of valvular type, mechanical-biological, and size on exercise hemodynamic of normally-functioning mitral prosthesis. Thirty-seven patients with mitral prosthesis, mean age 56 +/- 10 years, underwent exercise Doppler echocardiography. Peak and mean prosthetic gradient were obtained at rest, during and at maximal exercise with a nonimaging transducer. Mechanical prosthesis were 23 and biological valves 14. Valvular size was less than 26 mm in 7 patients and more than 28 mm in 20 patients. Exercise increased the heart rate from 80 +/- 14 to 143 +/- 22 (p < 0.001), peak gradient from 11.4 +/- 4 to 26.1 +/- 7 mm Hg (p < 0.001) and mean gradient from 4.8 +/- 1 to 13.7 +/- 5 mm Hg (p < 0.001). We found similar peak (11.4 +/- 3 & 11.3 +/- 4) and mean gradient (3.4 +/- 1 & 2.9 +/- 0.7) at rest between mechanical and biological valves; at maximum exercise, peak (26 +/- 7 & 26 +/- 6) and mean gradient (13.9 +/- 6 & 13.2 +/- 4) were also similar. Prosthesis with > 28-mm-size compared with prosthesis < 26-mm-size showed minor peak gradient at second step (21.3 +/- 4 & 26.4 +/- 6, p < 0.05) and at peak exercise (25.4 +/- 7 & 29.8 +/- 8, ns). Hemodynamics on exercise using Doppler echocardiography was not influenced by valvular type (mechanical-biological) in normal mitral prosthesis. However, mitral prosthesis of small size showed worse on hemodynamics exercise than bigger ones.

Bioprosthesis↗