Cavitating lung lesion and hemoptysis in a young woman.
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Adolescent↗
Biomedical subjects
A Olazabal
Publications and source records attributed to A Olazabal.
Platelet count, antiplatelet therapy and pulmonary embolism--a prospective study in patients with hip surgery.
Pulmonary embolism (PE) is a serious complication following hip surgery. Trials of antiplatelet thromboprophylaxis indicated a substantial reduction in PE rate, and we prospectively studied the effect of a combination of low-dose heparin and two different antiplatelets. Furthermore, our experience in previous studies suggested that platelet count (PC) levels could be useful to reliably suspect PE at a very early stage, and we prospectively tried to confirm our previous findings. Ours is a prospective study in 459 consecutive patients operated on because of hip fracture (265) or elective hip replacement (194), aimed to determine: 1) whether the benefits of antiplatelets plus heparin on PE outweigh the risks; 2) to assess the clinical usefulness of PC monitoring in these patients, so as to confirm whether PE could be recognized early. It was a prospective, randomized, double-blind study. All patients received unfractioned heparin (7500 IU sc twice daily, starting 2 h before operation). In addition, they received aspirin (200 mg thrice daily, with meals), Triflusal (300 mg thrice daily, with meals), or placebo. Real time B-mode ultrasonography (US) was performed on all patients on the 8-9th day after surgery. Venography was performed in patients with normal US, if clinical symptoms suggested venous thrombosis. Twelve out of the 459 patients (2.6%) had to discontinue prophylaxis, because of major bleeding (6 patients), or gastric intolerance (6 patients). There were no significant differences between groups in either deep vein thrombosis (26 patients (18%) with aspirin, 18 (12%) with Triflusal, 26 (17%) with placebo), or PE development (7 patients (5%) with aspirin, 3 (2%) with Triflusal, 8 (5%) taking placebo).(ABSTRACT TRUNCATED AT 250 WORDS)
Aged↗
Occult cancer in patients with acute pulmonary embolism. A prospective study.
We prospectively studied 78 consecutive patients with acute pulmonary embolism (PE) to determine the most appropriate workup study for searching for hidden cancer. After a careful physical examination, the following tests were performed: erythrocyte sedimentation rate (ESR), complete blood cell counts, biochemistry, carcinoembryonic antigen levels, chest radiograph, upper gastrointestinal endoscopy, and abdominal ultrasound. If a malignant lesion was suspected, further appropriate tests were performed. After hospital discharge, periodic follow-up was performed on all patients in our outpatient clinic. A malignant lesion was detected in 9 of 78 patients: in 7 of them, cancer was diagnosed during the hospital admission because of acute PE. All but one of these 7 patients were asymptomatic, except for PE symptoms. In three of them some abnormalities on physical examination led to the diagnosis of cancer; in the remaining three patients the diagnosis was suspected from abnormal results of blood tests. Cancer was detected several months after hospital discharge in two additional patients: an esophageal cancer was diagnosed 5 months later in one of the 23 patients who refused endoscopy; and a colonic carcinoma was detected 21 months after hospital discharge in a patient in whom colonoscopy was not performed at the time of hospital admission. When considered overall, cancer was more commonly found in patients with "idiopathic" PE as compared with patients with known risk factors for PE development (6 of 21 patients vs 3 of 51 patients; p < 0.05). On the other hand, one patient died because of massive recurrent PE after a biopsy sample was obtained because of a prostatic node. Gross hematuria had developed shortly after biopsy, and any attempt to increase heparin doses was followed by recurrent hematuria. According to our experience, any decision about procedures that potentially involve bleeding should be carefully individualized in patients with acute PE.
Acute Disease↗
Case report: CT diagnosis of nonobstructive left paraduodenal hernia.
The preoperative diagnosis of paraduodenal hernias (PH) can only be made radiologically. PH are seldom diagnosed preoperatively unless they cause bowel obstruction. We report an unusual case of a nonobstructive left PH diagnosed preoperatively by computed tomography (CT). The CT findings of internal hernias are discussed.
Abdomen, Acute↗
Deep venous thrombosis and the risk of pulmonary embolism. A systematic study.
The influence of several diseases and clinical conditions on the presence of pulmonary embolism (PE) in a large series of patients with deep venous thrombosis (DVT) in the lower extremities was analyzed prospectively. Lung scan findings from a series of 434 consecutive patients with DVT (with and without symptoms of PE) were studied and then correlated to five clinical variables: age, sex, elapsed time since clinical symptoms had appeared in the leg to diagnosis, degree of proximity of venous thrombus, and the presence or not of several risk factors that could have predisposed to thrombus development. According to scintigraphic findings, 164 patients were considered to have PE (asymptomatic in 76 of them), while 200 patients were classified as having only DVT. Lung scan was considered to be indeterminate for PE in 70 patients, and they were not included in the study. No differences were found in terms of age, sex, interval of time elapsed since onset of symptoms to diagnosis, or in the degree of proximity of the thrombus. However, several differences between groups were found when comparing the presence or absence of several predisposing factors for thrombosis: DVT developing in immobilized patients was associated with a significantly lower incidence of PE as compared with nonimmobilized patients (p = 0.005). Conversely, patients with a history of venous thromboembolism (VTE) had a significantly higher rate of embolism (31/51 vs 133/313; p = 0.01). On logistic regression analysis, a history of VTE showed a statistically significant association with more than a twofold higher risk of having PE for patients with such an antecedent. Our findings suggest that different pathophysiologic pathways could perhaps explain differences in embolic potential.
Causality↗
Case report: uncommon radiological and pathological features of giant colonic diverticula.
A case of multiple giant sigmoid diverticula is described in which a barium enema revealed two giant diverticula communicating with the sigmoid lumen. Both diverticula were located on the mesenteric border of the sigmoid colon, and histologic examination showed mucosal and serosal layers with no evidence of smooth muscle. The pathogenesis, pathology, radiological manifestations and differential diagnosis of this rare condition are discussed.
Aged↗
Cyclophosphamide and ifosfamide combination as neoadjuvant chemotherapy for locally advanced nonsmall-cell lung cancer: a meta-analytic review.
Twenty-three patients with marginally resectable and unresectable non-small-cell lung cancer (stages IIIA and IIIB) were treated by neoadjuvant chemotherapy. All patients received three cycles of preoperative chemotherapy with two alkylating agents, cyclophosphamide 2.5 g/m2 intravenously (i.v.) and ifosfamide 3.5 g/m2 i.v., mesna 12 g/m2 was given additionally to prevent drug hematuria. Six of 23 patients (26%) had partial response. Of the seven patients who underwent thoracotomy, two were completely resected, but with macroscopic residual disease. Mean time to progression for the whole group was 7 months. Fifteen patients had progression of disease, with local metastases only in six, and distant metastases in eight. After administering 52 chemotherapy cycles, cyclophosphamide-ifosfamide doses were cut down, as eight of 16 patients required hospitalization for fever during neutropenia nadirs. This two-alkylating (non-cisplatin) regimen, unlike cisplatin-based regimens, was ineffective, and further trials are not recommended.
Aged↗
[An analysis of calcium pidolate absorption and a comparison with that of a salt in common use, gluconate-lactate-carbonate, in postmenopausal osteoporosis].
The absorption of calcium pidolate is studied in 10 females suffering from osteoporosis by oral overload compared to the results of the glucono-lactate-carbonate. 405 mq of Ca pidolate produced a higher excretion of calcium by urine and an increase of Ca levels in blood than that produced by 1000 mq of Ca glucono-lactate-carbonate. The tolerance and the lack of side effects were the common feature in both salts. There were no effects on parathyroid glands nor bone resorption. We concluded that calcium pidolate is a safe and efficient treatment for osteoporosis because of easy absorption, which is very helpful in maintaining the calcium balance.
Absorption↗
Alterations in the nuclear volume of neurones from the hypothalamic magnocellular nuclei of fetuses born to rats subject to chronic alcoholism.
Previous authors have noticed alterations of the neuroendocrine system in the offspring of chronically alcoholic animals. Forty Sprague-Dawley rats, were used fed a liquid control diet and a 5%-alcohol liquid diet (Lieber and DeCarli). They were divided into four groups: Control (C), Pair Fed (P), Embryonic alcohol (E) and Fetal alcohol (F). Results obtained in the statistical analysis were as follows: from the paraventricular nucleus: between E and F, E and P, E and C, p less than 0.001. F and C p less than 0.01. P and C p less than 0.005. Between F and P there were no significant differences. From the supraoptic nucleus: E and P, E and C p less than 0.001. F and P p less than 0.025, F and C p less than 0.01. Between E and F, P and C there were no significant differences.
Animals↗
Whole pelvic osteomyelitis: unusual finding in staphylococcal sepsis.
We describe an infrequent case of combined infection of bone, articulation and lung by Staphylococcus aureus, with affectation of all pelvic bones. Studies with 99m Tc pyrophosphate were repeatedly negative, becoming positive following the appearance of radiological signs.
Adolescent↗
Emphysematous pyelonephritis.
A case of emphysematous pyelonephritis which was diagnosed by conventional radiology and confirmed by ultrasonography, computed tomography, and surgery is described. The etiology and pathogenesis of this severe infection are discussed, and the usefulness of the various noninvasive radiologic methods for the diagnosis and management of the infection is reviewed.
Emphysema↗
Anomalous inferior vena cava with lumbar vein thrombosis: CT diagnosis.
A case of thrombosis of the ascending right lumbar vein in a patient with infrahepatic interruption of the inferior vena cava and azygos-hemiazygos continuation is reported and the CT findings are described.
Cholecystectomy↗
A giant cell tumor of the thumb: a case report.
Giant cell tumors of the flexor sheath are the second most common tumors of the hand. We present a case that is unusual in the extent of the tumor and the pronounced bony invasion, which is rare. Preoperative diagnosis was complicated by a history of gout in our patient.
Giant Cell Tumors↗
Variceal bleeding. A review of a recent experience.
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Adult↗
Effects of indomethacin, aspirin, and fat-free diet on experimental pancreatitis in the rat.
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Amylases↗
Failure of glucagon in the treatment of alcoholic pancreatitis.
Glucagon has been claimed to be an effective treatment for pancreatitis, but the studies reporting this were either uncontrolled or did not use concurrent controls, and none were double blind. To evaluate the efficacy of glucagon for alcohol-related pancreatitis, we performed a controlled, randomized, double blind study. Twenty-six patients with pancreatitis associated with alcohol ingestion received either glucagon or placebo in addition to intravenous fluids, nasogastric suction, and meperidine as needed. There were no statistically significant differences between the group which received glucagon and the group which did not in any of 12 parameters which included symptoms, signs, laboratory tests, and requests for analgesia. We conclude that glucagon in addition to conventional therapy is no better for the treatment of alcoholic pancreatitis than conventional therapy alone.
Alcoholism↗
The parathyroid glands in experimentally induced hypergastrinemia in the rat.
The morphology of the parathyroids in rats with hypergastrinemia, induced by antral exclusion, was compared with that of glands from untreated rats and animals from which the main source of gastrin- 17 was excluded (antral resection). Fourteen weeks after induction of hypergastrinemia the volume of the parathyroids was significantly increased owing to hyperplasia of the parenchymal cells. Removal of the antral gastrin-producing capacity of the same duration was not accompanied by any significant changes in the parathyroids. These findings suggest that hypergastrinemia could be a stimulus for the development of hyperplasia of the parathyroids, and that it may be an etiological factor in the production of hyperparathyroidism.
Animals↗
Acetylsalicyclic acid and gastrointestinal propulsion in the rat.
The possible influence of moderate amounts of acetylsalicyclic acid (ASA) on gastric emptying, duodeno-gastric reflux and small bowel propulsion was studied in rats with permanent gastric and duodenal tubes. The ASA-containing or the control solution was introduced intra-gastrically half an hour before the simultaneous administration of differently labeled radioactive test meals into the stomach and the duodenum. ASA was given as 7.5 or 15.0 mM solution in 100 mM hydrochloric acid or in 100 mM sodium chloride. After 15 minutes the gastrointestinal propulsion was examined. No effect of the ASA treatment was noted. No increase in duodeno-gastric reflux was found in the ASA-treated animals.
Animals↗