Biomedical subjects

D Carballo

Publications and source records attributed to D Carballo.

5 recordsLinked to original sources

PubMed2002

Role of echocardiography in the evaluation of syncope: a prospective study.

OBJECTIVE: To study the role of echocardiography in the stepwise evaluation of syncope. DESIGN: A prospective observational study with an 18 month follow up. SETTING: University teaching hospital providing primary and tertiary care. SUBJECTS: 650 consecutive patients with syncope and clinical suspicion of an obstructive valvar lesion, or with syncope not explained by history, physical examination, or a 12 lead ECG, who underwent bidimensional Doppler transthoracic echocardiography. MAIN OUTCOME MEASURES: The causes of syncope were assigned using published diagnostic criteria. Echocardiography was considered diagnostic when confirming a suspected diagnosis, or when revealing occult cardiac disease explaining the syncope. RESULTS: A systolic murmur was identified in 61 of the 650 patients (9%). Severe aortic stenosis was suspected in 20 of these and was confirmed by echocardiography in eight. Follow up excluded further cases of aortic stenosis. In patients with unexplained syncope (n = 155), routine echocardiography showed no abnormalities that established the cause of the syncope. Echocardiography was normal or non-relevant in all patients with a negative cardiac history and a normal ECG (n = 67). In patients with a positive cardiac history or an abnormal ECG (n = 88), echocardiography showed systolic dysfunction (left ventricular ejection fraction < or = 40%) in 24 (27%) and minor non-relevant findings in the remaining 64. Arrhythmias were diagnosed in 12 of the 24 patients with systolic dysfunction (50%), and in 12 of the 64 remaining patients (19%) (p < 0.01). CONCLUSIONS: Echocardiography was most useful for assessing the severity of the underlying cardiac disease and for risk stratification in patients with unexplained syncope but with a positive cardiac history or an abnormal ECG.

Aged↗

PubMed2001

Prospective evaluation of patients with syncope: a population-based study.

PURPOSE: To determine the diagnostic yield of a standardized sequential evaluation of patients with syncope in a primary care teaching hospital. PATIENTS AND METHODS: All consecutive patients who presented to the emergency department with syncope as a chief complaint were enrolled. Their evaluation included initial and routine clinical examination, including carotid sinus massage, as well as electrocardiography and basic laboratory testing. Targeted tests, such as echocardiography, were used when a specific entity was suspected clinically. Other cardiovascular tests (24-hour Holter monitoring, ambulatory loop recorder ECG, upright tilt test, and signal-averaged electrocardiography) were performed in patients with unexplained syncope after the initial steps. Electrophysiologic studies were performed in selected patients only as clinically appropriate. Follow-up information on recurrence and mortality were obtained every 6 months for as long as 18 months for 94% (n = 611) of the patients. RESULTS: After the initial clinical evaluation, a suspected cause of syncope was found in 69% (n = 446) of the 650 patients, including neurocardiogenic syncope (n = 234, 36%), orthostatic hypotension (n = 156, 24%), arrhythmia (n = 24, 4%), and other diseases (n = 32, 5%). Of the 67 patients who underwent targeted tests, suspected diagnoses were confirmed in 49 (73%) patients: aortic stenosis (n = 8, 1%), pulmonary embolism (n = 8, 1%), seizures/stroke (n = 30, 5%), and other diseases (n = 3). Extensive cardiovascular workups, which were performed in 122 of the 155 patients in whom syncope remained unexplained after clinical assessment, provided a suspected cause of syncope in only 30 (25%) patients, including arrhythmias in 18 (60%), all of whom had abnormal baseline ECGs. The 18-month mortality was 9% (n = 55, including 8 patients with sudden death); syncope recurred in 15% (n = 95) of the patients. CONCLUSION: The diagnostic yield of a standardized clinical evaluation of syncope was 76%, greater than reported previously in unselected patients. Electrocardiogram-based risk stratification was useful in guiding the use of specialized cardiovascular tests.

Adult↗

PubMed2000

Assessment of a recombinant antigen versus natural hypodermin C for the serodiagnosis of hypodermosis in cattle.

An indirect ELISA test using as antigen a recombinant parasite protein, hypodermin C, was developed to measure Hypoderma-specific antibodies in cattle sera and compared with natural hypodermin C. To evaluate the field efficacy of the ELISA test, 334 serum samples were collected from cows raised at farms in Galicia for a serological survey. Compared with an ELISA based on natural parasite antigen, the recombinant hypodermin C gave excellent results, with a sensitivity of 95.8% and a specificity of 95.7%. Considering the cut-off point, with the recombinant hypodermin C, 70.9% of the animals had positive levels of antibodies to Hypoderma and with natural hypodermin C, 73.6%. Recombinant hypodermin C appears to be a useful alternative to the natural parasite antigen for the serodiagnosis of Hypoderma sp in cattle.

Animals↗

PubMed1993

[Trichuriasis in Cuba].

A representative sample of the Cuban population (11,364) is studied by using Willis and direct coproparasitological techniques. It was found that Trichuris trichiura is the most prevailing intestinal parasite (17.8%). A higher frequency of this kind of geohelminthiasis in people living in Cuban rural zones is seen. A prevalence peak is found in ages from 6 to 9 years, and a higher association of parasitism was found in those with worst hygienic and sanitary conditions.

Adult↗

PubMedDate not supplied

[Isoenzymatic characterization of strains of Entamoeba histolytica isolated from Cuban patients and foreigners from Africa].

An analysis was made of the isoenzyme patterns of 61 Entamoeba histolytica strains: 42 from Cuba and 19 from Angola Mozambique and Ghana. By means of these patterns the non-pathogenic nature of the Cuban strains (Group 1) was shown. It coincided with the clinical characteristics of the infection in the carriers. Among the imported strains were 2 samples with pathogenic patterns II corresponding to 1 dysentery case and to 1 asymptomatic patient, and also non-pathogenic ones (I, II, III and XVIII).

Angola↗