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Biomedical subjects

C Cortés

Publications and source records attributed to C Cortés.

At least 19 recordsLinked to original sources
PubMed1992

[Characteristics of severe esophagitis in patients with collagen diseases].

Connective tissue disease may alter esophageal function generating symptoms due to gastroesophageal reflux and motor disturbances. Fifteen patients with connective tissue diseases and severe esophagitis defined by the presence of esophageal stenosis or ulcerations were studied. Diagnosis was made with radiologic, endoscopic and manometric studies. Dysphagia was present in 11 and gastroesophageal reflux in all. All patients has an hypotensive and shorter lower esophageal sphincter. Better therapeutic results were obtained with surgical treatment.

Adult↗
PubMed1992

[Mortality from childhood and adolescent leukemia in Spain (1951-1985)].

PURPOSE: To study the mortality due to leukaemia during childhood and youth in Spain in the period 1951-1985. MATERIAL AND METHODS: The mortality for all types of leukaemia in that period was studied in three aspects: (a) By reviewing the rates of specific mortality for ages under 20 years, at quinquennial intervals and per millions of inhabitants of those ages. (b) Studying the mortality per cohorts of births at five-year intervals from 1951-1955 to 1981-1985. (c) Attaining the statistical value, "observed deceased" of leukaemia in people under 15 years of age for the period studied and on each year of that period, and comparing such value with the number of "expected deceased", with regard to the reference year, 1965. RESULTS: A decreasing trend was observed along the whole period. As for ages, there seems to be some tendency to stabilisation of the mortality in the last five-year period, 1981-1985 (there is a decrease only in the 15-18 age-group). These data were confirmed when assessing the mortality per "birth cohorts" or generations, and after plotting the figures of "observed" and "expected" mortality in accordance with the previous evolution. CONCLUSION: It was inferred that regard to the mortality of childhood and youth leukaemia, in Spain the situation has improved markedly, doubtless as a result of better therapeutical approach. This evolution closely resembles the patterns of the most developed countries from a sanitary standpoint.

Adolescent↗
PubMed1990

Lay understanding of low-frequency electric and magnetic fields.

People do not start with a blank slate when they hear risk-communication messages. All such messages are processed through existing knowledge structures and understanding. Hence, to design effective and reliable risk-communication materials one must understand the state of people's knowledge--correct and incorrect--about an issue. We developed a simple "mental model" of what people minimally need to know to make informed decisions about field-related issues. Then we performed studies to explore how and to what extent respondents of various groups understood physical properties of 60-Hz electric and magnetic fields. Actual knowledge of respondents was then compared with the predicates of the model. Electrical engineering juniors and semi-technical employees of utilities displayed a good command of most of the concepts in the simple model, but little awareness of the limits to their knowledge. Lay respondents correctly knew only a few of the simplest elements of the model, but they displayed a much greater awareness of the limits to their knowledge. Both lay and semi-technical respondents were found to share several misconceptions. On average, they correctly rank-ordered some common field-exposure conditions by field strength, but they could not differentiate between electric and magnetic fields and could not differentiate among field strengths associated with different appliances. Most respondents dramatically underestimated the range of actual field strengths. Many respondents understood that field strength decreases with distance from a source, but they underestimated the rate of decrease. In contrast to X-rays and microwaves, which respondents appeared to think about in rather similar terms, 60-Hz fields were not thought of as being highly similar to any other agent, although the closest parallels were found with ultrasound. Changes in mood, thought, and behavior, and the existence of an "electrical aura," were all seen as plausible results of exposure to a 60-Hz field. Although lay respondents displayed a variety of incomplete and confusing ideas, most of these ideas probably do not pose significant obstacles to the learning of a correct, simple, mental model.

Communication Barriers↗
PubMed1989

Late results of a prospective randomised study comparing forceful dilatation and oesophagomyotomy in patients with achalasia.

Late results in 81 patients with achalasia treated in a prospective randomised study comparing forceful pneumatic dilatation with the Mosher bag and surgical anterior oesophagomyotomy by abdominal route, are reported. There were no deaths from either of the treatments. Two patients (5.6%) had a perforation of the abdominal oesophagus after pneumatic dilatation and were excluded from late follow up. In patients having surgery at radiological evaluation there was gullet diameter significantly increased at the oesophagogastric junction and decreased at the middle third of the oesophagus. One patient was lost from follow up and one died of an oesophageal carcinoma, leaving 95% of excellent results at the late follow up (median 62 months). Resting gastro-oesophageal sphincter pressure decreased significantly to approximately 10 mmHg; this was maintained five years after surgery. By contrast, in patients having pneumatic dilatation, there were good results in only 65% (follow up median 58 months), with 30% failures. One patient was lost from follow up and one developed oesophageal carcinoma. Measurement of resting gastro-oesophageal sphincter pressure after dilatation was highly predictive of the outcome. The study shows that surgical treatment offers a better final clinical result than pneumatic dilatation with the Mosher bag.

Adolescent↗
PubMed1989

[Cancer of the testis: risk factors and evolution of mortality in Spain (1951-1983)].

Herein we report the results of a study on the mortality trends of testicular cancer in Spain from 1951-1983. The study showed that following a long period of increased mortality, overall mortality rates for all age groups have dropped in recent years. However, the mortality rate has increased for the young and middle-aged males and has dropped for the older age groups. A similar finding has been observed for other countries such as the United States. We have attempted to interpret these changes based on the risk factors for this type of cancer.

Age Factors↗
PubMed1989

Late subjective and objective evaluations of antireflux surgery in patients with reflux esophagitis: analysis of 215 patients.

The results of late subjective and objective evaluations of antireflux surgery in 215 patients with reflux esophagitis who were included in a prospective, controlled study are reported. A special protocol--including analysis of reflux symptoms, radiology, endoscopy, esophageal manometry, and standard acid reflux test--was designed. The surgical technique used was as follows: (1) highly selective vagotomy, (2) closure of the hiatus, (3) calibration of the cardia, (4) posterior gastropexy, and (5) fixation of the gastric fundus to the diaphragm. The operative mortality rate was 0.4%, and postoperative complications occurred in 5% of the patients. Only 5% of the patients were lost from the late follow-up. A total of 150 patients with more than 5 years since operation were completely evaluated. Reflux symptoms greatly decreased after surgery. Radiologic studies were normal in 93% of the patients, and endoscopy showed a long-standing healing of macroscopic esophagitis in 83% of the cases. Manometric features were analyzed in 159 patients before and in 115 patients 1 year after surgery. A significant increase in lower esophageal sphincter pressure was demonstrated, as well as an increase in the total length and abdominal length of this sphincter (p less than 0.0001). The increase in gastroesophageal sphincter was evaluated in 46 patients 1 year and 5 years after surgery, and this showed a maintenance of sphincter competence. Esophageal clearance markedly improved after surgery, and the standard acid reflux test, which was positive in 100% of cases before surgery, persisted positive in 16% (p less than 0.001). Final clinical evaluation 5 years after surgery demonstrated excellent and good results in 85% of the patients and failure or reoperation in 8% of the patients.

Adolescent↗
PubMed1987

Cross-reactivity among five major pollen allergens.

We have studied the cross-reactivity between L. perenne, S. cereale, P. pratense, C. dactylon, and Ph. communis. The results obtained demonstrate that L. perenne, S. cereale, and P. pratense have strong cross-reactivity. C. dactylon has a number of allergens that cross-react with the rest of the grasses studied but they are minor allergens. Ph. communis possesses a moderate cross-reactivity with the species of the group but it has, as well, individual allergens.

Allergens↗
PubMedDate not supplied

[Thalassemic syndromes and anesthesia].

Thalassemic syndromes are produced by a quantitative defect in the synthesis of globin chains of hemoglobin. They are classified according to the severity of the clinical picture and to the type of globin chain that is affected. Physiopathology, clinical picture, and treatment of thalassemias are discussed in this work. Thalassemia minor does not create, in general, anesthetic problems. In cases of thalassemia major one should consider not only problems derived from the severity of the anemia it self, but also those related to transfusional therapy, and to bony malformations that may disturb tracheal intubation. Discussion on the management of homozygotic thalassemia during the pre, per, and postoperative phase completes this revision.

Adult↗
PubMedDate not supplied

[Anesthetic approach in 2 patients with pulmonary lymphangiomyomatosis].

Pulmonary lymphangiomyomatosis (PLM) is an idiopathic disease of females in fertile age. It results in respiratory failure characterized by obliteration of the small airways, emphysema, formation of bullae, hemoptysis, pneumothorax, pulmonary fibrosis, severe hypoxemia and reduced carbon monoxide diffusion capacity. The major lymphatic ducts are also involved, resulting in chylous pleural effusion and ascites. Pulmonary abnormalities improve objectively and subjectively after surgical therapy, which consists in bilateral oophorectomy. Its evolution results in death in no more than 10 years. We report the anesthetic approach to 2 patients with PLM. Patient 1 was a female who had already been diagnosed of PLM and had received medical and surgical therapy, requiring reoperation for the resection of cystic intestinal masses and abdominal eventration. Patient 2 had been scheduled for bilateral oophorectomy after a diagnosis of PLM. We discuss the clinical condition of both patients, the course of the disease, the previous treatments and the anesthetic technique in each case.

Adult↗
PubMedDate not supplied

[A rare complication of endotracheal intubation: posterior luxation of the left arytenoid cartilage].

The luxation of the arytenoid cartilage is a very uncommon complication of endotracheal intubation. Symptoms usually are aphonia, dysphonia, pain or discomfort in the throat, odynophagia and laryngeal stridor. It may be due to several factors: the pressure of the convex aspect of the tube on the arytenoid, traumatic or prolonged intubations, reintubations within a short period, or some systemic diseases. We report a case of posterior luxation of the left arytenoid in a patient who had been anesthetized for the radical cure of a left inguinal hernia. The clinical features developed when he recovered from anesthesia, with aphonia and discomfort in the throat. The diagnosis was made by indirect laryngoscopy. Treatment with nonsteroidal antiinflammatory agents was instituted. Aphonia disappeared after 2 weeks and dysphonia persisted. The patient became asymptomatic with corticosteroids on the fourth week after operation. Early diagnosis under laryngoscopic vision is recommended, with adequate therapy to prevent fibrosis of the cricoarytenoid joint with permanent sequelae.

Adult↗