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C Villanueva

Publications and source records attributed to C Villanueva.

At least 55 records · Page 3Linked to original sources
PubMed1993

[Splenic rupture in the course of pancreatitis].

We present the case of a young patient with a history of alcoholism and chronic relapsing pancreatitis, who developed an associated pseudocyst. During the course of the disease he presented an acute abdomen due to splenic rupture and splenic thrombosis, disclosed by laparotomy. Following splenectomy and drainage the evolution was satisfactory. In the present paper we discuss the presentation of splenic vein thrombosis and splenic rupture as a rare complication of pancreatic pseudocyst.

Adult↗
PubMed1993

[Determination of the tumor marker CA 72-4 in gastric carcinoma].

In this study, the authors determined the sensitivity and specificity of the new tumor marker CA 72-4 in detecting adenocarcinoma of the stomach. CA 72-4 serum levels were investigated in 279 patients consisting of: 100 control subjects, 88 patients with benign gastrointestinal disease and 91 patients with gastrointestinal cancer (31 with gastric cancer). We used a cut-off of 5 U/ml. The specificity of CA 72-4 was 91% and the sensitivity was 68%. Highest levels of CA 72-4 were found in patients with more advanced tumor (stages III-IV) and four of 5 patients with stage I had elevated levels of this tumor marker. These findings suggest that the use of serum CA 72-4 measurements may be more useful than other tumor markers in the diagnosis, prognosis and detection of recurrence in patients with gastric cancer. Although CA 72-4 can be elevated in other gastrointestinal adenocarcinomas, it can be useful in alerting the clinician to the possible presence of an intraabdominal neoplasm.

Adenocarcinoma↗
PubMed1993

[Acute colonic pseudo-obstruction (Ogilvie syndrome) after nephrectomy for renal carcinoma: persistence after decompressive colonoscopy and spontaneous remission].

A 65-year-old male patient presented acute dilatation in the ascendant colon on the third post-operative day following nephrectomy due to renal adenocarcinoma. No changes in colonic diameter were seen after decompressive colonoscopy and, while the patient was asymptomatic, conservative therapy was instituted and the picture was resolved in just a few days. The case is used to review the issue of acute colonic pseudo-obstruction and its relationship to urological operations.

Acute Disease↗
PubMed1992

Pallidal hyperintensity on magnetic resonance imaging in cirrhotic patients: clinical correlations.

Patients with cirrhosis show increased signal intensity in the globus pallidus on T1-weighted magnetic resonance imaging of the brain. This abnormal appearance of the basal ganglia has been related to the severity of liver failure and to the presence of portal-systemic shunting, although its cause and clinical significance remain unknown. We prospectively assessed the metabolic, neurological and neuropsychological statuses of 30 stable cirrhotic patients and correlated these clinical variables with computed measurements of globus pallidus signals. Some metabolic variables denoting disease severity appeared to be significantly related to image changes, although the strongest association was found with plasma ammonia levels. After adjustment for ammonia level, on multiple regression analysis, the other variables were not significant. Furthermore, pallidal changes were associated with specific neurological symptoms and neurological functions, symptoms and functions that also had a significant correlation with ammonia levels. Our findings suggest that globus pallidus signal abnormality could arise as a marker of brain impairment related to hyperammonemia.

Aged↗
PubMed1992

Norfloxacin prevents bacterial infection in cirrhotics with gastrointestinal hemorrhage.

To assess the efficacy of selective intestinal decontamination with norfloxacin in the prevention of bacterial infections in cirrhotic patients with gastrointestinal hemorrhage, 119 patients were included in a prospective randomized study. Group 1 (n = 60) received norfloxacin orally or through a nasogastric tube, 400 mg twice daily for 7 days beginning immediately after emergency gastroscopy; group 2 (n = 59) was the control group. We found a significantly lower incidence of infections (10% vs. 37.2%; P = 0.001), bacteremia and/or spontaneous bacterial peritonitis (3.3% vs. 16.9%; P less than 0.05), and urinary infections (0% vs. 18.6%; P = 0.001) in patients receiving norfloxacin, as a consequence of decrease in the incidence of infections caused by aerobic gram-negative bacilli. The decrease in mortality observed in the treated group (6.6% vs. 11.8%) did not reach statistical significance. The cost for antibiotic treatment showed a 62% reduction in the treated group compared with the control group. The results show that selective intestinal decontamination with norfloxacin is useful in preventing bacterial infections in cirrhotics with gastrointestinal hemorrhage.

Adult↗
PubMed1992

[Multidisciplinary study of cerebrovascular accidents: I. Definition, design, and general results].

Cerebrovascular accidents (CVA) constitute a major cause of adult cardiac cardiovascular mortality in Chile. From July 87 to August 89 we prospectively studied 300 patients with CVA utilizing a multidisciplinary approach. Besides clinical evaluation this included brain CT scan (48 hrs), glucidic and lipid profile. Occlusive CVA were additionally studied with 2D-Echocardiogram, 24 hr Holter, Cerebral Angiography and/or carotid Duplex Echotomograph, and a second brain CT scan was performed within the first week. We found a 62.3% incidence of cerebral infarcts, 28.3% of cerebral hemorrhages and 9.3% of transient ischemic attacks. Cerebral infarcts were found to be cardiac related in 33.5% of cases, whereas 13.2% were lacunar, 4.4% were atherothrombotic and 14% had no precise etiology. Hypertension was associated to cerebral hemorrhages in 76% of cases, 26% of which were intracranial. At 2 months of follow-up 16.3% of patients were severely handicapped and mortality was 19.3%. We have confirmed that cerebral infarcts constitute the most common cause of CVA and most of them are cardiac related. Hypertension appears to be the most important cause of cerebral hemorrhage. A multidisciplinary approach to cerebrovascular accidents allowed a more precise diagnosis and contributed to implement appropriate therapeutic and preventive strategies. Proper identification of high risk patients could contribute to decrease the high incidence and mortality of CVA in our community.

Aged↗
PubMed1992

Double-level spinal injury resulting in "en bloc" dislocation of the lumbar spine. A case report.

We report the case of a 21-year-old man with a unilateral lumbosacral dislocation together with a fracture of L1 resulting in "en bloc" dislocation, which is difficult to classify from an anatomopathological and biomechanical point of view. Unilateral lumbosacral dislocation is likewise an infrequent injury with less than 10 cases previously reported. Its association results in an anterior displacement to the left of the whole lumbar spine. To our knowledge, this displacement "en bloc" of the lumbar spine represents a rotatory dislocation of the same, an injury which we have not seen described until now in the literature.

Adult↗
PubMed1991

[Portasystemic shunt in the treatment of gastropathy caused by portal hypertension].

Gastropathy by portal hypertension constitutes the second cause of digestive hemorrhage in these patients following esophagogastric varices. Beta-blocker drugs seem efficient in treatment as occasionally does therapeutic endoscopy. The case of a patient with chronic liver disease with upper digestive hemorrhage is presented. The patient did not respond to medical treatment with beta-blockers nor to endoscopy (thermic and sclerosant). Portocaval anastomosis was performed with no posterior hemorrhagic relapse. The use of shunt surgery has been suggested in this pathology given the rarity of its presentation in patients with this type of operation. The satisfactory evolution of the patient seems to confirm this hypothesis.

Esophageal and Gastric Varices↗
PubMed1991

[Immunoglobulin A and human immunodeficiency virus type 1 infection in parenteral drug abuse addicts].

BACKGROUND: To evaluate the usefulness of serum immunoglobulin A (IgA) as a prognostic marker of human immunodeficiency virus type 1 (HIV-1) in parenteral drug abusers (PDA). METHODS: The serum IgA levels and HIV-1 antibodies were assessed in 374 PDAs admitted for infective diseases or for treatment of addiction. RESULTS: The prevalence of HIV infection was 70%; the frequency of serum IgA above the upper normal limit (440 mg/dl) was 8% in seronegative and 4% in seropositive subjects (NS). The IgA levels in the 274 seropositive subjects, classified for infective stages, were significantly higher in those fulfilling the criteria for acquired immunodeficiency syndrome (AIDS) or AIDS related complex (group IV) than in asymptomatic subjects (group II) or in those with generalized lymphadenopathy (group III) (p less than 0.01). CONCLUSIONS: Serum IgA levels in PDAs with HIV infection may be a useful marker of progression to AIDS.

AIDS-Related Complex↗
PubMed1991

[Vaccination against the hepatitis B virus in alcoholics].

BACKGROUND: The risk of hepatitis B virus infections is high among alcohol abusers, and vaccination has been evaluated in previous studies. However, the response has been low with the usual doses and schedules. METHODS: In the present controlled trail a group of 14 alcohol abusers was vaccinated following a rapid schedule with a dose twice the usual one. Their response was compared to that of a second group of 16 alcohol abusers vaccinated in the usual way. Both groups were compared to a third one consisting of 30 healthy individuals. RESULTS: At the end of the program 83% of the healthy controls responded, with a mean anti-HBs titer of 1130.3 mU/ml. The anti-HBs titer achieved in both groups of alcohol abusers was lower that in healthy individuals (p less than 0.05). 56% of the alcohol abusers vaccinated with the usual program responded (with a mean titer of 80.1 mU/ml), and so did 66% of those vaccinated with high doses (mean titer 63.3 mU/ml). CONCLUSIONS: These results indicate that the poor response of alcohol abusers to HBV vaccine does not improve with increased doses and a rapid schedule.

Adult↗
PubMed1991

[The prognostic signs of digestive hemorrhage due to peptic ulcer].

UNLABELLED: A series of clinical and endoscopic signs have been described, which have predictive value in the evolution and mortality of peptic ulcer hemorrhage. Accepted clinical parameters of severity are: age above 60, associated severe disease, hypovolemic shock at admission. Endoscopic prognostic signs for persistence or recurrence of hemorrhage are: active bleeding, either spurting or oozing, a visible vessel. Other endoscopic signs such as the presence of a dark clot, black dots, red spots over the ulcer, do not have prognostic value. IN CONCLUSION: The presence of active bleeding or a visible vessel in a patient with peptic ulcer bleeding, especially when aged more than 60 and with associated severe disease is indicative of recurrence or persistence of the hemorrhage and of greater mortality. In this group of patients therapeutic endoscopy is mandatory.

Age Factors↗
PubMed1991

[Multifactorial analysis of patients with endometriosis in an institutional program of assisted reproduction].

It is a retrospective and transverse study with an analysis of results from patients submitted to intrauterine insemination (IIU), intratubal gamete transfer (GIFT) and in vitro fertilization and embryo transfer (FIVTE), at the Clinic of Assisted Reproduction, Instituto Nacional de Perinatología in Mexico City. From 134 cycles of patients submitted to IIU, 113 corresponded to women with diagnosis of sterility from non determined cause, and 21 to cases with endometriosis, and at least one permeable tube. From the first group, 22 pregnancies were obtained, for a monthly fertility rate of 19.4%; and from the second one, 12 pregnancies with a fertility rate of 56%. This, which is very high , may be explained by the relatively small number of cases in the second group, or else, by the influence of a previous medical treatment for endometriosis; the square Chi analysis shows a P less than 0.01 in the two groups. In the GIFT and FIVTE cases, from which 35 cycles were analyzed, per each procedure, there were 10 pregnancies, 9 for GIFT and one for FIVTE; the amount is very limited in order to obtain conclusions, but it seems that there is a proportional tendency in GIFT to less amount of pregnancies in women with endometriosis. The analysis of hormonal follow up did not show differences in the groups, and the averages may be useful to determine, early, the cancellation, or not, of an stimulation cycle. Finally, in FIVTE cases there is a diminution of fertilization index in women with endometriosis (53%), as compared with the cases without disease (80%).(ABSTRACT TRUNCATED AT 250 WORDS)

Cross-Sectional Studies↗
PubMed1991

[An analysis of hospital bacterial infections in cirrhotic patients undergoing selective intestinal decontamination].

Cirrhotic patients with ascites and low levels of ascitic fluid C3 and total protein and cirrhotic patients with gastrointestinal hemorrhage are at high risk of infection. Selective intestinal decontamination with oral norfloxacin is useful to decrease the incidence of infections in cirrhotic patients at high risk. This study analyzes hospital acquired bacterial infections in cirrhotic patients with ascites and low levels of total protein in ascitic fluid (n = 53) and cirrhotic patients with gastrointestinal hemorrhage (n = 26), both submitted to selective intestinal decontamination with norfloxacin during the hospitalization. Seven patients developed eight infections (8.8%): three patients with ascites and low levels of total protein in ascitic fluid and four patients with gastrointestinal hemorrhage (5.6% vs 15.3%, pNS). Gram negative bacilli were not isolated in any case, but Gram positive cocci were isolated in seven cases. These results suggest that Gram positive cocci must be empirically covered when infection is suspected in cirrhotic patients submitted to selective intestinal decontamination. The analysis of antibiograms in these infections showed a high sensitivity of Gram positive cocci to amoxycillin and clavulanic acid, which could be used as empirical treatment when infection is suspected in these patients.

Ascites↗
PubMed1990

Injection therapy of bleeding peptic ulcer. A prospective, randomized trial using epinephrine and thrombin.

A prospective randomized trial involving 64 patients with bleeding peptic ulcers was performed to assess the efficacy of two modalities of injection therapy. The inclusion criterion was the presence of active bleeding or a visible vessel at emergency endoscopy. Thirty-two patients were treated with epinephrine (Group A) and 32 with epinephrine plus thrombin (Group B). Permanent hemostasis was achieved in 81.3% Group A, and 84.4% Group B patients, and therapy failures occurred in 18.6% and 15.6%, respectively. Mortality was nil in both groups. There were no differences in the requirement for emergency surgery, or in the number of transfusions in the two groups. A second elective endoscopy was performed in 49 patients between the 3rd and the 5th day after admission, proceeding to a second injection therapy if a visible vessel was still seen. There were no failures among re-injected patients. With one exception, none of the failures occurred in patients in whom a second endoscopy was done. Our results suggest that injection therapy, which is a simple technique, should be considered as the initial treatment of choice in bleeding peptic ulcer. The addition of thrombin to epinephrine does not improve the results of the method. An early second endoscopy and local therapy if a visible vessel is still present, may further improve the results.

Aged↗
PubMed1990

[Trans-laparoscopic intratubal insemination].

Intratubal insemination was practiced in 21 patients during laparoscopy either for infertility study or second look laparoscopy for medically treated endometriosis, stimulation of ovulation was performed during the menstrual cycle with clomiphene for five days, at the sixth day of the cycle we start the administration of human menopausal gonadotrophins. Ovulation was monitored with ultrasound and estradiol determinations. From 30 to 36 hours before laparoscopy chorionic gonadotrophin was administrated, homologous capacitated sperm were introduced directly in the fallopian tubes results in two pregnancies (9%). One terminated in abortion for the first trimester, the other resulted in a normal pregnancy with birth at term.

Adult↗
PubMed1990

[Translaparoscopic intratubal insemination].

Intratubal insemination was practiced in 21 patients during laparoscopy either for infertility study or second look laparoscopy for medically treated endometriosis, stimulation of ovulation was performed during the menstrual cycle with clomiphene for five days, at the sixth day of the cycle we start the administration of human menopausal gonadotrophins. Ovulation was monitored with ultrasound and estradio determinations. From 30 to 36 hours before laparoscopy corionic gonadotrophin was administrated, homologous capacitated sperm was introduced directly in the fallopian tubes results in two pregnancies (9%). One terminated in abortion for the first trimester, the other resulted in a normal pregnancy with birth at term.

Adult↗