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Biomedical subjects

D Nuñez

Publications and source records attributed to D Nuñez.

11 recordsLinked to original sources
PubMed1999

Direct versus indirect signs of traumatic aortic injury revealed by helical CT: performance characteristics and interobserver agreement.

OBJECTIVE: The purpose of this study was to evaluate the relative value of and interobserver agreement on direct versus indirect (hematoma) signs of traumatic aortic injury using helical CT. MATERIALS AND METHODS: From April 1994 through January 1997, 40 patients who were suspected to have traumatic aortic injury and who underwent contrast-enhanced helical CT had subsequent proof or exclusion of aortic injury. All available CT scans of these patients were combined with CT scans of 13 randomly chosen patients that had been initially interpreted as negative, and clinical follow-up showed no evidence of aortic injury. Two emergency radiologists and a nonemergency radiologist who were unaware of clinical outcome performed independent review of these cases to evaluate for mediastinal hematoma, periaortic hematoma, and direct signs of aortic injury. RESULTS: Direct signs of injury were seen on helical CT by both emergency radiologists in all 17 cases of aortic injury with no false-positive interpretations. The nonemergency radiologist failed to observe subtle direct signs in two cases of aortic injury, but patient management would not have been adversely affected. All observers had more false-negative interpretations for both mediastinal hematoma and periaortic hematoma than for direct signs. Interobserver agreement was higher for direct signs (kappa = .93) than for either mediastinal hematoma (kappa = .65) or periaortic hematoma (kappa = .71). CONCLUSION: In this study, helical CT revealed direct signs of traumatic aortic injury that were more accurate and more often observed than were indirect signs. Emphasis on direct signs should improve confidence in using helical CT to evaluate traumatic aortic injury.

Adolescent↗
PubMed1996

Traumatic occlusion of the renal artery: helical CT diagnosis.

OBJECTIVE: Eight patients with traumatic occlusion of the renal artery were retrospectively reviewed to assess the diagnostic contribution of helical CT and to determine whether the information it provides can replace angiographic data in patient evaluations. MATERIALS AND METHODS: We reviewed the medical records and imaging studies of eight patients with renal artery occlusion caused by blunt abdominal trauma. All patients were scanned using a helical protocol that included an 8-mm collimation with a 1:1 pitch and a monophasic IV injection of iodinated contrast material. The timing of the imaging studies, the type of surgical treatment, and the patient outcome were tabulated. Evaluated data included the location of the occlusion as depicted by helical CT and angiography, whether a CT nephrogram was obtained, the presence of a peripheral rim effect, and the nature of associated injuries. RESULTS: Helical CT revealed occlusion of a main renal artery in seven patients and obstruction of a main branch in one patient. In all cases the occlusion occurred within the proximal 2 cm of the renal artery. In five patients, the findings were depicted equally well by helical CT and angiography. In two patients, the helical CT findings were confirmed by surgery and autopsy, respectively. Significant associated injuries were revealed in seven patients. The CT nephrogram was absent in seven patients and partially present in one patient. The peripheral rim effect was seen in six patients. CONCLUSION: Basic contrast-enhanced helical CT can reliably reveal traumatic occlusion of the renal artery and depict the level of obstruction.

Abdominal Injuries↗
PubMed1985

Schistosoma mansoni: neurotransmitters and the mobility of cercariae and schistosomules.

The concentration-dependent action of alkyl-isothiouroniums on Schistosoma mansoni cercariae, ranging from partial to total abolition of locomotor and flame cell movements, and/or suppression of virulence, is due to H1-histamine receptor inhibition. Correspondingly, H1-receptor inhibitors of widely different chemical structure, such as clemizol, diphenhydramine, brompheniramine, and promethazine, in 0.03-0.06 nM concentrations, induced an analogous cercarial immobilization reversed by addition of excess histamine. In contrast, the H2-receptor inhibitors cimetidine and metiamide did not immobilize cercariae. Histamine, acetylcholine, and serotonin, added to cercarial suspensions, showed no direct activity. Their participation in the mechanism of cercarial mobility was shown by the dose-dependent effects of antagonists, such as the serotonin antagonist methysergide and the acetylcholinesterase inhibitor physostigmine. These effects were not reversible by addition of serotonin and acetylcholine, respectively. A histamine-irreversible cercarial immobilization induced by the H-liberator 48/80 suggested that, besides H1-receptor inhibition, H-liberation and/or depletion also participated in mobility and survival. The detection of histamine in the cercaria corroborated the participation of histaminergic mechanisms. S. mansoni schistosomules collected from the mouse lung reacted to H1 antihistamines like cercariae, with a dose-dependent reduction of mobility and somatic deformation, such as vacuolization, granulation, and caecal enlargement.

Acetylcholine↗
PubMed1985

Transgastric drainage of pancreatic fluid collections.

Eight pancreatic fluid collections in seven patients were successfully drained percutaneously through a transgastric approach. The drainage catheters were left in place for 3-6 weeks to promote the formation of a fistulous tract between the stomach and the pancreatic collection. Computed tomography (CT) was used for diagnosis and for planning of the access route. Combined sonography and fluoroscopy were used for guidance. Radiologic follow-up examinations (CT and sinograms) have shown no recurrences (3-12 months). No complications were encountered.

Drainage↗
PubMed1978

Unusual complications of renal cyst puncture.

The authors present a case of subcapsular hematoma with compromise of renal function and a case of arteriovenous communication as two infrequent complications of renal cyst puncture.

Aged↗
PubMedDate not supplied

Subhepatic collections complicating laparoscopic cholecystectomy: percutaneous management.

Ten patients with subhepatic fluid collections complicating laparoscopic cholecystectomy were successfully treated by interventional radiological procedures. The series included five abscesses, three hematomas, one biloma, and one serous collection. Abdominal pain or fever developed from 3 to 21 days after the laparoscopic intervention. All patients were asymptomatic 72 h after percutaneous drainage and there were no complications related to the procedure. Subhepatic fluid accumulations are common findings after laparoscopic cholecystectomies and have been considered an unreliable indicator of infection or other postoperative complications. However, the significance of these collections should not be underestimated in symptomatic patients. In such cases we propose diagnostic aspiration and drainage, when necessary, to safely and promptly establish the precise diagnosis and treatment. More serious complications can be avoided by early percutaneous intervention.

Adult↗