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Biomedical subjects

C G Montero

Publications and source records attributed to C G Montero.

At least 19 recordsLinked to original sources
PubMed1999

Bacillus cereus prosthetic valve endocarditis.

Bacillus cereus is a ubiquitous organism that often contaminates microbiological cultures but rarely causes serious infections. Reports of B. cereus endocarditis are infrequent. Infection in patients with valvular heart disease is associated with significant mortality and morbidity. We describe a case of B. cereus endocarditis involving a mechanical mitral prosthesis that resolved after replacement of the prosthetic valve. We also review the previous cases reported in the literature.

Bacillaceae Infections↗
PubMed1999

Pulmonary hydatidosis: surgical treatment and follow-up of 240 cases.

OBJECTIVE: We review a series of 240 patients treated surgically for pulmonary hydatid cyst in our center between 1966 and 1988, assessing the results with our surgical technique, which involves a novel needle aspiration device designed by Professor D. Figuera, and postoperative treatment protocol. PATIENTS AND METHODS: The majority (60.4%) of the patients were from areas endemic for hydatid disease. The mean age of the patients at the time of the surgical procedure was 31.5 +/- 7.2 years (range: 4-70 years). A trocar-suction device was used for the needle aspiration of 276 (92%) of the 300 cysts encountered in the 240 patients. The remaining 24 cysts were removed integrally by means of different surgical techniques such as cyst enucleation, lobectomy, segmentectomy and atypical pulmonary resection. The residual cavity was treated by pericystectomy and eversion to the pleural surface in 238 cases (86.2%) and by capitonnage in 38 (13.7%). High vacuum suction (-30 cm H2O) was employed in every case. Depending on when the procedure was performed, the patients were treated with mebendazole or albendazole according to the protocol designed by Bekhti. RESULTS: Clinical assessment of the symptoms and plain chest X-ray led to the correct diagnosis in 228 cases (95%). In six (2.5%), imaging studies such as ultrasonography, computed tomography and nuclear magnetic resonance were required, and in the remaining six cases (2.5%), the diagnosis was established intraoperatively or in the subsequent histopathological study. One hundred and seventy patients (70.8%) presented a solitary lung cyst, while the remaining 70 (29.2%) were found to have multiple cysts in one or more lobes of one or both lungs. In addition, 45 patients (18.7%) presented hepatic cysts and 25 (10.4%) had cysts in other locations. After 18 years of follow-up, the survival rate was 94.6%. Of the surviving patients, 98.3% were free of pulmonary hydatid disease and 95.1% were free of hydatid disease. CONCLUSIONS: The trocar-suction device employed here for needle aspiration of hydatid cysts has demonstrated its efficacy in preventing the rupture of the cyst and its possible dissemination. With its use, the parasite is eradicated and the residual cavity can be excised.

Adolescent↗
PubMed1997

Improved distribution of pulmonary flush solution to the tracheobronchial wall in pulmonary transplantation.

This report describes the experimental results obtained with conventional (pulmonary artery, PA) flushing versus retrograde perfusion (via left atrium, LA) using 99mTc-labeled macroaggregated albumin (MAA-99mTc) to ascertain the distribution throughout the tracheobronchial (TB) tree in 10 Large-White pigs. Lung preservation was achieved with 4 degrees C Euro-Collins solution (60 ml/kg) instilled via PA (n = 5) or LA (n = 5). Simultaneously, MAA-99mTc was given using the same respective route and the isotope uptake quantified at different TB levels after heart-lung block harvest and dissection of all tissue adjacent to TB: proximal and distal trachea and right and left main bronchi. Retrograde distribution resulted in a significantly higher 99mTc count compared to the PA route (p < 0.01).

Animals↗
PubMed1990

Polar lipids of non-alkaliphilic Halococci.

Until recently, only one species of Halococcus has been recognized, namely, H. morrhuae, but a large number of extremely halophilic non-alkaliphilic cocci have now been isolated from hypersaline habitats in Spain and classified into four phenons (A-D); one of the phenon D strains has been classified as a new species, Halococcus saccharolyticus. Examination of the lipids of H. saccharolyticus and four strains of phenons A-C showed the presence in all of them of C20-C20 and C20-C25 diether molecular species of phosphatidylglycerophosphate (PGP), phosphatidylglycerol (PG) and phosphatidic acid (PA); a monounsaturated isoprenoid C20-C20 (phytanyl-phytenyl) species of PGP; a sulfated diglycosyl diphytanylglycerol (S-DGD) with structure 2,3-diphytanyl-1-(6-HSO3-mannosyl-1-2-glucosyl)-glycerol, which is identical to the S-DGD-1 in Haloferax mediterranei; a phosphoglycolipid (P-TGD) tentatively identified as a phytanyl-phytenyl-(H2PO3-galactosyl-mannosyl-glycosyl)-glyce rol, and two unidentified glycolipids present only in traces. No phosphatidylglycerosulfate (PGS) was detected in any of the strains examined. This pattern of lipids appears to be characteristic of the strains of Halococcus from salterns in Spain, but studies of a larger number and variety of Haloccus are necessary to establish this conclusion with certainty.

Glycolipids↗
PubMed1989

Thrombectomy of the Björk-Shiley prosthetic valve revisited: long-term results.

Thrombotic obstruction of the Björk-Shiley prosthetic valve is a catastrophic complication, often leading to a fatal outcome. Worldwide experience with the Björk-Shiley valve supports the need for long-term anticoagulation to prevent entrapment of the disc. Replacement of the malfunctioning device is associated with a high mortality, and therefore a more expeditious method is desirable. It is our experience that simple thrombectomy may suffice in most occasions, even for the mitral position, and especially when done through a bicameral approach in order to visualize both supravalvular and infravalvular regions. The philosophy and results with thrombectomy and disc rotation in 12 cases of thrombotic occlusion of the Björk-Shiley valve are described. It is suggested that this method may be preferable to replacement of the thrombosed prosthetic valve in select patients.

Adult↗
PubMed1989

Outlet-strut fracture and disc embolization in 27-mm and smaller Björk-Shiley convexo-concave valves: historical overview and 3 case reports.

Outlet-strut fracture leading to primary failure of Björk-Shiley convexo-concave disc valves has only recently been reported in valves of 27-mm size and smaller. We now report an additional 3 cases of outlet strut failure in smaller convexo-concave valves, in a series of 899 implantations (overall incidence, 0.33%) of convexo-concave valves in various sizes and in 2 variant opening angles (60 degrees and 70 degrees ), during a 6-year period. All failures were confined to lots implanted during 1981 and 1982. We describe these 3 cases within the context of an historical overview of the Björk-Shiley tilting-disc valve, and propose methods of surgical intervention when this life-threatening complication arises.

Journal Article↗
PubMed1986

Infections in heart-lung transplant recipients.

Infectious episodes were analyzed in 14 heart-lung transplant recipients who survived more than one week after transplantation. These patients had higher rates of infection than heart transplant recipients at our institution (P less than 0.01) and greater than 90% of all infections were potentially life-threatening. A total of 67% of all infections involved the lung or thoracic cavity as a primary site, and most of the rest were disseminated viral or fungal infections. Pneumocystis carinii infections occurred in six patients and were more common in this group than in patients who received heart transplants in the same period (P less than 0.005). Two patients followed more than one year developed a syndrome of chronic sputum production and bronchial colonization with Pseudomonas aeruginosa, which required recurrent treatment with i.v. antibiotics for symptomatic relief. The high rate of pulmonary infections in these patients presents a challenge to clinical management, and suggests that intensive and invasive monitoring for pulmonary infection is desirable.

Adult↗
PubMed1986

Neuropathology of heart transplantation: 23 cases.

We reviewed the clinical histories, operative results, and neuropathologic findings of 23 consecutive patients who had heart transplants. Prolonged preoperative hypotension and failure of cerebral autoregulation of blood flow, followed by postoperative elevation of blood pressure beyond the limits of cerebral autoregulation, may account for the high incidence of neurologic complications (70%); 60% were vascular. Immunosuppressive therapy may have been responsible for the high incidence (20%) of opportunistic intracranial infections. Lymphoproliferative disorders occurred in three patients (13%).

Adolescent↗
PubMed1985

Surgical experience in descending thoracic aneurysmectomy with and without adjuncts to avoid ischemia.

Over the past twelve years, surgical treatment of descending thoracic aneurysms has been performed in 360 patients. Three different operative strategies were employed during resection to provide distal aortic perfusion by temporary bypass (Group 1, 75 patients) or shunt (Group 2, 22 patients) or to simplify the operative procedure with aortic cross-clamping alone (Group 3, 263 patients). The surgical results were determined primarily by patient-related and disease-related variables. Advanced age (older than 70 years), atherosclerotic cause, and emergency operation significantly increased the risks of early mortality and morbidity. The incidence of death (11.7%), paraplegia (6.5%), or renal failure (6%) was not reduced by the use of adjunctive perfusion, and bleeding complications increased significantly in Groups 1 and 2. Spinal cord injury was increased significantly by emergency operations, cross-clamp times exceeding 30 minutes, and extensive aneurysms (p less than 0.05). The risk of renal failure was increased by advanced age and atherosclerotic cause (p less than 0.05). With an experienced surgical team, the primary risks of descending thoracic aneurysmectomy are not influenced by the method of adjunctive perfusion, but are determined by patient factors such as the nature and extent of the aneurysm.

Adolescent↗
PubMed1985

Rewarming rate of the myocardium during aortic cross-clamp time: variations with different levels of body hypothermia.

Twenty patients underwent elective cardiac valve replacement at 20 degrees C of body hypothermia. Temperatures of the ventricles of both walls were monitored on 12 different sites. Distribution of myocardial temperature ranged between 24.3 and 29.3 degrees C for patients of Group I before cardioplegia delivery and 13.2 degrees C in the septum after cardioplegic infusion. Average temperatures for the anterior and posterior wall were 13.6 C and 15 degrees C in the left ventricle and 14.7 and 15 degrees C in the right ventricle. Myocardial temperatures ranged from 26 to 28.7 degrees C for patients of Group II. After cardioplegic arrest, septal temperatures averaged 14.9 degrees C. The recorded sites of the anterior and posterior left ventricle were 14.1 and 13.1 degrees C. The effects of rewarming on the different myocardial areas occurred according to a logarithmic equation, which is faster in the first 10 minutes. The data suggest that the myocardium can be adequately protected with 25 degrees C hypothermia when the cross-clamp period is shorter than 60 minutes. When longer ischemic periods are expected, myocardial protection is best accomplished with 20 degrees C hypothermia.

Journal Article↗