Biomedical subjects
E Monge
Publications and source records attributed to E Monge.
[Early postoperative surgical complications of orthotopic liver transplantation in adults (II)].
Early postoperative complications after liver transplantation are classified broadly as either medical or surgical. This review covers the main aspects of the pathophysiology and clinical management of the latter group. Surgical complications of liver transplantation are an important cause of morbimortality; their early diagnosis and treatment are therefore critical issues. Such complications are usually related to surgical technique and their correction often requires a second surgical procedure. The most common early postoperative complication, and one of the most serious ones, is hepatic artery thrombosis. Venous complications are less prevalent and biliary ones predominate in the late postoperative phase.
[Early postoperative medical complications of orthotopic liver transplantation in adults (I)].
The outcome of liver transplantation in Spain has improved since our earliest experiences with this type of surgery, mainly due to breakthroughs in surgical and anesthetic techniques. Careful postoperative care of the patient also plays a key role, however, by providing the early diagnosis that allows appropriate management of complications. Together, such improvements contribute to reducing the morbidity associated with liver transplantation and to greater survival and quality of life for recipients. Early postoperative complications are diverse in nature and for convenience can be classified as either medical or surgical. This review deals with the main medical complications.
Change in the histologic type of gastric carcinoma.
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Esophageal tuberculosis.
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Low peptic ulcer and high gastric cancer prevalence in a developing country with a high prevalence of infection by Helicobacter pylori.
We compared the prevalence rates of peptic ulcer (duodenal and gastric) and gastric cancer in 1,796 dyspeptic Peruvian patients with those reported in 2,883 similar patients from developed countries. The prevalence of total peptic ulcer was significantly lower, and that of gastric cancer significantly higher, in the Peruvian patients. The prevalence of gastric ulcer was lower but not significantly so. We deduced that the significantly lower prevalence of total peptic ulcer was directly related to the low prevalence rate of duodenal ulcer. We hypothesize that the reason for these differences was probably a higher prevalence of Helicobacter pylori-associated chronic atrophic gastritis with hypochlorhydria in the Peruvian patients. Hypochlorhydria decreases the predisposition to peptic ulcer (especially duodenal ulcer), and chronic atrophic gastritis may predispose an individual to gastric cancer.
Early detection of gastric cancer.
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Gastrointestinal endoscopy and arterial oxygen desaturation in high-altitude hospitals.
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Cuticular ultrastructure of Paragonimus from Costa Rica.
The surface ultrastructure of eggs, metacercariae, and adults of Paragonimus endemic to Costa Rica were examined under the scanning electron microscope. Two different morphological types of parasites were found. The most commonly found form was the "first type" (86%) corresponding to the previous descriptions of P. mexicanus. The metacercariae of this type showed an oral sucker surrounded by papillae clustered on the dorsal lip, the ventral sucker showed six internal and from 30 to 35 external papillae. The most evident difference in the "second type" was observed on the ventral sucker, because it showed an intermediate row of five to six papillae located between the internal and external papillae. In conclusion, the Paragonimus species of Costa Rica is P. mexicanus. The morphological differences seen could be a variation of the same species or another species.
Paragonimus mexicanus (Trematoda) in Costa Rica in two new intermediate hosts: Ptychophallus richmondi and Ptychophallus tumimanus (Crustacea: Decapoda).
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Pulmonary dirofilariasis in a Costa Rican man.
In a 33-year-old male Costa Rican who died of undetermined cause 2 hours after admission to hospital, autopsy revealed a small female Dirofilaria causing a recent hemorrhagic infarct unlike the pale coin lesion usually seen in pulmonary dirofilariasis.
A new definitive natural host of Angiostrongylus costaricensis (Morera and Céspedes 1971).
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[Natural infection of Ptychophallus tristani (Crustacea: Decapoda) by metacercariae of Paragonimus mexicanus (Trematoda) in Tabarcia de Mora, Costa Rica].
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[Immunological studies in hamsters (Cricetus auratus) infected with Schistosoma mansoni].
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[Anesthesia for cesarean section in a patient with von Hippel-Lindau disease].
We report the case of a pregnant 38-year-old woman at full-term who had a history of von Hippel-Lindau disease with neurological symptoms. She had previously undergone surgical removal of cerebellar hemangioblastomas. A cesarean delivery performed under general anesthesia was uneventful and the outcomes were excellent for both mother and fetus. General anesthesia was chosen because patients with von Hippel-Lindau disease often have asymptomatic spinal cord and intracranial involvement. As such involvement could not be ruled out, we preferred to avoid the risks related to regional anesthesia. One of the main features of von Hippel-Lindau disease is the presence of central nervous system hemangioblastomas, which are highly vascularized, slow growing tumors that may become enlarged during pregnancy. We describe the implications of the disease for anesthesia.
[Cholelithiasis in patients with liver cirrhosis].
We retrospectively studied 67 cirrhotic patients hospitalized in the service of gastroenterology of Hospital Daniel A. Carrión, Callao, Perú, between June 1993 and July 1995, aimed to determine the frequency of cholelithiasis and its main clinical and epidemiological features. Twelve out of 67 cirrhotic patients (17.91%) had cholelithiasis. 24% of women and 14.3% of men were affected (p > 0.05). The mean age of women and men were 57.33 and 57.5 years old respectively (range: 41-67 years old). The frequency of cholelithiasis did not increase with age and the proportionally most affected age group was 41-50 years (33.33%). Alcoholic etiology was the most often in cirrhotic patients with cholelithiasis (41.67%). The severity of liver disease influenced in the cholelithiasis frequency (p = 0.001) and 33.33% of patients with gallstones were in grade C of Child Pugh Score. Two thirds of patients were asymptomatic. We conclude: 1. Cholelithiasis in our cirrhotic patients more prevalent than in general population (17.91% vs 0.7-5%). 2. Age did not influence in cholelithiasis prevalence in our cirrhotic patients. 3. The severity of liver disfunction influenced in highly significant way (p = 0.001) on cholelithiasis prevalence. 4. Cirrhotic patients with gallstones had mostly (66.67%) an asymptomatic course.
[in vitro comparison of liquid antacids of commercial use].
The aim of our study was to compare the capacity of several liquid antacids to elevate the pH of a hydrochloric acid solution. An experimental model was designed to measure this capacity in different commercially available liquid antacids. Change in pH of an HCl solution was registered when each of the liquid antacids was added. We found differences between the 4 MgOH - ALOH antacids. Minimal difference was found between the 2 commercially available magaldrates.