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Biomedical subjects

A del Castillo Rueda

Publications and source records attributed to A del Castillo Rueda.

At least 19 recordsLinked to original sources
PubMed2006

[Waldemström s macroglobulinemia].

Waldenström s macroglobulinemia is an uncommon B-cell lymphoproliferative disorder characterized by bone marrow infiltration of luymphoplasmatic lymphoma, although sometimes there is a extramedullary lymphoma (nodal), with demonstration of an IgM monoclonal gammopathy. It must be distinguished from monoclonal gammopathy of undetermined significance and IgM- related disorders. The median survival of patients with Waldenström s macroglobulinemia averages 5 years. Asymptomatic cases should not be treated. Symtomatic cases could be treated with alkylating agents, nucleoside analogues (fludarabine or cladribine), and the monoclonal antibody rituximab. For the management of hyperviscosity and neuropathies plasmapheresis could be used successfully.

Antineoplastic Agents↗
PubMed2005

[What is the opinion of Spanish internists on osteoporosis?].

OBJECTIVE: To conduct an opinion survey on osteoporosis in Spanish internists. METHOD: Survey sent by mail and by personal visit to members of the Spanish Internists Society. Collection of data on opinion on the disease, diagnostic and therapeutic attitude and means available (general laboratory analyses, conventional radiology, biochemical markers of bone remodeling, densitometry and ultrasounds) and preference when choosing a certain treatment. RESULTS: A total of 538 internists answered. More than 90% of those surveyed consider that osteoporosis is a disease that should be treated by internists. A total of 93% consider that osteoporosis is a prevalent disease. More than 80% have access to densitometry. CONCLUSIONS: The majority of Spanish internists consider that osteoporosis is a disease that should be treated by internists and that it is a disease that enters into their action scope. In general, they have the means necessary for its study and treatment. Bisphosphonates constitute the drug of choice and calcium and vitamin D supplements are indicated in almost all the cases.

Aged↗
PubMed2005

[Satellite manifestations of internal diseases].

AIMS: Define the concept of satellite manifestations (SM) and to determine the number and types of them that appear in the diseases of each one of the subspecialties of the Internal Medicine. METHODS: 290 diseases are reviewed in agreements of Internal Medicine and specialties books and in each one are described the types of SM that they present. RESULTS: The respiratory diseases are the group that more SM presents and the less one the neurological. The most frequent type of SM are dermatological. The diseases that have more variety of types of SM are the endocrinologicals. Analyzing the percentages of every type of SM in relation with the number of diseases of every group, the highest are the dermatological SM in cardiac diseases. CONCLUSIONS: The SM are a very frequent phenomenon in the current medical practice and express the holistic character of the disease. His knowledge is indispensable in the internal medicine and subspecialties, where they can suppose a help in the diagnoses, though a bad knowledge of his reality can mean the opposite.

Cardiovascular Diseases↗
PubMed2005

[Histiocytic sarcoma: a case report and review of the literature].

Histiocytic sarcoma is a rare neoplasm, and its aetiology is unknown. It is a malignant proliferation of neoplastic cells showing immunophenotypic and morphologic features similar to tissue histiocytes. The clinical course of histiocytic sarcoma is usually agressive. The signs and symptoms of histiocytic sarcoma are systemic symptoms (fever, weight loss), hepatosplenomegaly, adenopathies, intestinal obstruction, rash and pancytopenia. We present the case of a 75 years old woman, with fever, weight loss, anorexia, fatigue, splenomegaly and pancytopenia. Bone marrow examination showed the diagnosis of histiocytic sarcoma.

Aged↗
PubMed2004

[Technical project for the management and functioning of an Internal Medicine care unit].

The Internal Medicine Services have a central role in the medical care in our hospital system both as to the volume of patients attended and their variety, reflecting of the preparation and multi-tasking ability of their professionals. The current norms for coverage of heads-of-service demands the presentation of a management project that must test our knowledge, skills and aptitudes for the clinical and medical management and in order to reflect them in a document of commitment with the management and with our fellows who are a part of the care unit. The person in charge of the service, as boss, agent or leader, is the one who must mark the strategic lines, to indicate the aims, to define the projects, to coordinate the tasks and to evaluate the results with other offers to obtain agreed-upon aims controlling the different points of view. Our professional and social commitment is: sharing clinical management with ethics, quality and welfare safety, to offer our patients (consumer or users) the best results (effectiveness), with useful measurements (efficacy) and with the minors drawbacks and costs (efficiency). The aim of this work is to offer the elements that are necessary for the accomplishment and introduction of a project of clinical management in a service of internal medicine, highlighting its methodology and the most important problems than can arise as well as the possible care alternatives.

Education, Medical↗
PubMed2003

[Case finding of iron overload in a university hospital].

BACKGROUND: The epidemiologic importance of iron overload disorders and the clinical lack of its diagnosis led us to an active search of cases among the hospitalized patients in a general university hospital. This situation will make it possible to have a larger and earlier number of diagnosis together with a preventive intervention and an effective treatment. PATIENTS AND METHODS: A transverse study was performed on patients admitted to a fifteen beds ward in the internal medicine department. They have all been applied, without exclusion criteria, the iron metabolism parameters survey. The transferrin saturation (TS), due to its sensitivity, specificity and positive predictive value, has been considered appropriate for the phenotypic screening of the iron overload disorders. Subjects with fasting TS of 45% or more were considered as risk population. RESULTS: The study comprised 117 patients with an average age of 69.9 +/- 15.04. The high-risk population rate was 13.8% with an average age of 60.8 +/- 20.17, as compared to the low-risk population with an average age of 71.3 +/- 13.7 (p < 0.05). The most outstanding illnesses associated to the high-risk population are chronic hepatitis and diabetes mellitus (31.25%). An 18.7% of the cases show undernourishment. CONCLUSIONS: The iron overload is a prevalent illness whose early diagnosis requires a high clinical suspicion. The active search among the hospitalized patients, who have been made a TS, benefits the new cases detection. The TS is a screening technique with a high diagnostic profitability if you evaluate correctly the false positives. For that reason, we think the TS has to be included within the analytic requests which patients are made when admitted to hospital.

Adult↗
PubMed2001

[Osteoporosis in patients admitted to an internal medicine service of a university general hospital].

OBJECTIVE: To ascertain the incidence of osteoporosis and epidemiological factors in patients admitted to an Internal Medicine Service of a University General Hospital in Madrid, Spain. We also took into account the reasons for admission, associated diseases, and the preventive and therapeutic diagnostic implications. PATIENTS AND METHODS: The analytical, descriptive, retrospective and transversal study of one hundred patients over fifty years of age admitted to an internal medicine service during 1997, obtaining in addition to the clinical discharge report, epidemiological data with regard to the radiological diagnosis of osteoporosis, the reason for admission, past history, the prevention and treatment of the initial complaint as well as the osteoporosis previous diagnosis. RESULTS: 26% of those patients included in the survey had radiologic criteria of osteoporosis although only in 1 per cent of them had osteoporosis been diagnosed previously. The main risk factors, apart from the age and sex, are the associated illnesses which cause malnutrition and immobilization, and the use of drugs, especially heparin. CONCLUSIONS: Osteoporosis is a condition common in patients above 50 especially women, who are admitted to an Internal Medicine Service. A quarter of those patients admitted have osteoporosis. Very few are diagnosed and treated. In this group of patients apart from the habitual risk factors, are added those for the associated disease generally chronic, and the treatment they receive. During their stay in the hospital osteoporotic patients are three times more likely to receive heparin and other drugs which aggravate osteoporotic, than non osteoporotic patients. For that reason the risk of fractures is greater and the need for prospective diagnostic studies is even more necessary in this group of patients.

Aged↗
PubMed2000

[Primary hemochromatosis in asymptomatic young patients].

OBJECTIVES: In order to increase our knowledge of adult haemochromatosis epidemiology and its clinical behaviour in young patients, we studied 4 patients from 3 pedigrees with idiopathic haemochromatosis. METHODS: Diagnostic criteria were: 1) Discarding the presence of secondary haemosiderosis. 2) Histological and histochemical confirmation of hepatic iron overload. Mean age at time of diagnosis was 25.2 years. Male/female ratio was 1. RESULTS: All of them were clinically asymptomatic, what shows the main difference with juvenile haemochromatosis, presenting earlier and more aggressively. Physical examination could not find abnormalities in any case. Regarding analytical studies, the main results were as follows: mean serum iron level was 209.5 mg/dl (s = 37.8), transferrin 206 mg/dl (s = 24.5), transferrin saturation was 77.4% (s = 9); ferritin, ASAT & ALAT were abnormal exclusively in the 2 males), the other measurements being between normal limits in all cases. Abdominal MRI showed an impaired hepatic signal in 2 cases. Liver biopsy was accomplished in 3 of them, showing massive deposits of hemosiderin in the hepatocytes in the 2 male cases and chronic hepatitis in one of them. There was no evidence of damage to other organs. Genetic studies showed that the 2 siblings were homozygous for the HFE 845GAEA (C282Y) mutation and in the other 2 cases HLA-A3,B7 was found to be associated. At present, after a year or more, all of them remain asymptomatic, liver function tests and mean serum ferritin levels are within normal limits, IST is < 65%, while Hb continues being > 11 g/dl. CONCLUSIONS: To conclude, we would like to emphasize the extraordinary importance of early diagnosis and careful treatment in this common and remediable illness (otherwise lethal), to reach a normal and symptoms-free lifespan.

Adolescent↗
PubMed1999

[Serum and pulmonary angiotensin converting enzyme as a marker of acute lung injury in an experimental model of adult respiratory distress syndrome].

OBJECTIVE: To know if the determination of the angiotensin converting enzyme in serum (SACE) and lung (LACE) may be useful as a marker of acute lung injury (ALI) in the adult respiratory distress syndrome (ARDS). METHOD: By reproducing in a experimental model of ALI with oleic acid in dogs which simulate the early stage of ARDS, we have correlated the pathologic and analytical changes observed with the results of the determinations of SACE and LACE. RESULTS: We have found sequential pulmonary lesions (congestion, edema, hemorrhage polynuclear infiltration and thrombosis) and biological alteration (hypoxemia, pulmonary hypertension, early leukopenia and final leukocytosis, thrombopenia and hypofibrinogenemia) that reproduce the typical changes of ARDS, together with the decrease of SACE--slow and progressive--and LACE--abrupt in the onset and maintained during the experiment--. CONCLUSIONS: The LACE is a good marker of the beginning of the lesion because its decrease coincides with the first pathological changes (congestion) and with the hypoxemia, pulmonary hypertension and leukopenia, maintained without changes, during the whole experiment. On the other hand, the SACE corresponds as an inespecifical reactant, marker of acute inflammation and loss of pulmonary endothelium, because its progressive decrease evolutioned with the pathological lesions and the analytical changes. In conclusion, the sequential determination of SACE has a prognostic and evolutive value in comparison with the LACE, which has a diagnostic value from the beginning of the experiment of ALI and maintained throughout.

Animals↗
PubMed1994

[Third-level hospital emergency department visits by patients with acute asthma. 1990].

BACKGROUND: In the natural history of an asthmatic patient's disease, emergency room visits can be significant, incidental, or accidental occurrences from the therapeutic, preventive, clinical, or epidemiological perspective. METHODS: In order to find out the characteristics of the severely asthmatic patients who visit the third-level emergency room of the hospital asking for medical attention, we studied their visits, as opposed to those of other patients, for a one-year period. RESULTS: We registered 477 emergency care patients for asthma (1.30/day) which implies visits to the hospital watch of 0.71%. It is maintained 24 hours a day, predominantly in the first three days of the week (52.41%), the last ten days of the month (36.68%), the second trimester of the year (34.48%), and the month of May (20%). Compared to the rest of the population who also went for emergency room care, the asthmatic patient had lower average age (44 vs. 50), a majority of women (67.29% vs. 48%) and more frequent visits (36.74% vs. 18.59%). In comparison with studies in other countries, we register a higher number of admission but a lower of relapses (4.06%). CONCLUSIONS: Emergency room visits by severely asthmatic patients is an epidemiological index of the public health significance of the disease as it is a reflection of the degree of control and type of asthma. It is an important factor in determining demand of emergency care given the frequency of visits and the rates of admission and relapse.

Acute Disease↗