Biomedical subjects

A Rodríguez Velasco

Publications and source records attributed to A Rodríguez Velasco.

5 recordsLinked to original sources

PubMed2004

[Fat embolism syndrome after surgery to replace the femoral stem of a hip prosthesis].

A 66-year-old woman developed hemodynamic instability, oliguria, prostration, fever, and coagulopathy 4 hours after surgery to replace the femoral stem component of a hip prosthesis under a combined subarachnoid-epidural block. Dyspnea and tachypnea developed, and a petechial rash appeared 24 hours later. The diagnosis was fat embolism after other possible causes were ruled out. Supplementary oxygen, fluid replacement therapy, and inotropic support were started. The patient's condition improved and she was discharged from the postoperative recovery unit 5 days after admission. Although fat embolism usually appears in young men after large bone fractures, it should be considered when symptoms consistent with this diagnosis arise in patients who have undergone orthopedic surgery so that appropriate treatment can be started early.

Aged↗

PubMedDate not supplied

[Neonatal hemochromatosis. Report of 3 autopsy cases].

INTRODUCTION: Neonatal hemochromatosis is a disease that starts in utero, characterized by severe fibrosis or cirrhosis and siderosis of the liver and other organs without affecting the mononuclear fagocytic system. The most important clinical features are severe hepatic failure at birth and hypoglycemia. The diagnosis is made excluding other diseases more frequently seen in the neonatal period and with at least two of the clinicopathologic criteria delineated by Knisely. METHODS: A retrospective analysis of the autopsies of newborn done at the Department of Pathology of the Hospital de Pediatría, C.M.N. SXXI, IMSS, a tertiary care facility in the period 1989 from 1997. Those cases with primarily hepatic disease as the main diagnosis were chosen. The degree of siderosis was determined cualitatively. The amount of Fe and copper in the liver and spleen in samples fixed in formalin was obtained using X ray fluorescence in the Instituto Nacional de Investigaciones Nucleares, two control cases were also tested. RESULTS: Only four out of 210 autopsies of newborn babies were found to have hepatic disease as a main diagnosis but without an etiology determined. In three of such cases the diagnosis of neonatal hemochromatosis was made. All patients were male with ages six, 29 and 36 days, one with Down's syndrome. The ratio of iron deposits in liver/spleen in hemochromatosis' cases was higher to 1.5 in the liver in contrast to the two control cases. CONCLUSIONS: These cases showed the utility of the autopsy in establishing the adequate diagnosis in three cases of neonatal hemochromatosis. The importance of establishing an accurate diagnosis is to recognize it as an entity with a lethal course, that can be potentially managed with liver transplant as well as genetic counseling to the family. A remarkable finding in the study of these cases was the ratio of iron concentration in the liver and spleen that allowed to discard other causes of siderosis. To our knowledge this finding has never been recorded.

Copper↗

PubMedDate not supplied

[Pathology of the papillary muscles].

Anatomoclinical findings in 21 cases of papillary muscle (PM) damage found in 4,000 consecutive autopsies are reviewed. Mitral PM muscles were involved in 17 cases, the posteromedial muscle in 11 patients, in 8 of these with necrosis (N) in 3 with fibrosis (F), in 2 with rupture. The mitral antero-lateral (MAL) was involved in 4 cases, by myocardial infarction (MI), fibrosis, hemorrhage and infectious endocarditis (IE). Both mitral PM were involved in two patients (MI and endomyocardial fibrosis). Tricuspid PM involvement was found in 4 cases. In two because of MI and the two remaining with fibrosis. In the 12 cases with MI microscopic examination showed, PM necrosis of variable magnitude: in the 7 cases with F, there was increased interstitial tissue by connective tissue; in the case with IE there was severe inflammatory reaction with microabscess formation and in one case, a small central longitudinal artery was damaged, a finding not previously described. Mitral PM infarction caused regurgitant murmurs, increase in heart size, heart failure and death from acute pulmonary edema or serious arrhythmias. There was no radiological evidence of left atrial enlargement. ECG findings were not useful in the diagnosis. Based on this anatomoclinical experience considerations are made about other diagnostic and surgical methods.

Humans↗

PubMedDate not supplied

[Calcified aortic stenosis due to healed experimental bacterial endocarditis].

We studied the role of bacterial endocarditis in the development of aortic valve stenosis. A femoral arterio venous shunt was performed in nine dogs with the method previously proposed by Lillehei. We induced bacteremic infection with the administration of streptococcus mitis (1 x 10(10)) 10 ml once a day for 15 days these bacterium were sensible to penicillin. All dogs were treated with 1,000,000 U of benzatinic penicillin and sacrificed between 28-102 days after the bacterial inoculation ended. In one dog we observed bacterial endocarditis in the mitral and aortic valves and in other three dogs there was an aortic valve stenosis with calcium deposits in the body and in the free edges of the aortic valve with evident irregular stenosis as seen in man.

Animals↗

PubMedDate not supplied

[Aspiration biopsy].

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Biopsy, Needle↗