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Biomedical subjects

E Valiente

Publications and source records attributed to E Valiente.

14 recordsLinked to original sources
PubMed1997

[Cerebral blood flow study using SPECT in patients with memory disorders].

INTRODUCTION: Global amnesia (AG) is a dysfunction of memory, in which there is a sudden incapacity to remember recent events and assimilate new information. The aetiology is currently under discussion. The main hypotheses under consideration are an ischemic mechanism and an epileptic mechanism. OBJECTIVE: To study the cerebral blood flow in patients with temporary global amnesia (AGT) or permanent global amnesia (AGP) using functional neuroimaging techniques. MATERIAL AND METHODS: Four patients were studied. Two had severe alterations of fixation memory which had been present for months. The other two had a sudden loss of recent memory, although space-person orientation and immediate memory remained normal. In all cases the cerebral blood flow (FSC), was assessed by single photon emission tomography (SPECT), using Tc-HMPAO as the radio tracer. RESULTS: We describe 4 patients, 2 men and 2 women aged between 42 and 64.2 with AGT and the others with AGP. On SPECT there was temporal hypoperfusion in all 4 patients. In 2 cases there was associated parietal hypoperfusion and in 1 case there was frontal hypoperfusion. CONCLUSIONS: These findings suggest that AGT and AGP are of vascular origin and that SPECT is a useful diagnostic technique in patients with AG.

Adult↗
PubMed1997

[Quality and life style as risk factors in acute cerebrovascular disease].

INTRODUCTION: In some series of patients with acute cerebral vascular disease (CVD) it has been seen that, prior to the episode of CVD, the patients already had a poorer quality of life than other people of their age. The object of this study is to evaluate their previous life style and quality of life as risk factors (RF) in acute CVD. MATERIAL AND METHODS: A case-control study was done of a total of 151 patients admitted to two hospitals with acute CVD and 151 persons, who were not hospitalized and acted as the control group, paired (one to one) for age, sex and hospital. In both groups data were collected regarding basic general health, previous quality of life (Nottingham Health Profile-NHP-, life style and self-perception of social support. The relative risks were estimated by calculating the odds ratios and conditional logistic regression. RESULTS: Regular moderate physical exercise acts as a protective factor with an OR of 0.32 (IC 95%: 0.14-0.76). Consumption of tobacco and alcohol increased the risk of CVD but did not reach statistical significance. No relationship was found between perceived social support and risk of CVD. Physical mobility, evaluated using the NHP showed a statistically significant negative association with acute CVD (OR: 0.32; IC 95%: 0.14-0.71). CONCLUSIONS: Our results seem to suggest that the previous overall quality of life cannot be considered a RF in acute CVD, except for physical mobility as evaluated on the NHP. Reduction of this constitutes a RF and moderate physical exercise behaves as a protective factor.

Acute Disease↗
PubMed1997

[Stressful life events as risk factors in acute cerebrovascular disease].

INTRODUCTION: The influence of psychosocial stress on the origin of acute cerebral vascular disease (CVD) has received very little attention. The objective of this paper is to evaluate the role of psychosocial stress due to events occurring in daily life as a risk factor (RF) in acute CVD. MATERIAL AND METHODS: A case-control study was done of a total of 151 patients who were admitted to two hospitals with acute CVD and 151 persons, who where not hospitalized and acted as the control group, paired (one to one) for age, sex and hospital. In both groups data were collected regarding basic general health, consumption of tobacco and alcohol and stressful incidents (SI) in their lives during the previous two years. The stress derived from SI was measured on the 'Inventory of SI and Recent Experiences' of Holmes and Rahe. The frequency of serious SI was also considered. The relative risks were estimated by the odds ratio calculations. RESULTS: A positive association was found for the RF defined in relation to acute CVD. We did not find any relationship between psychosocial stress derived from SI and risk of acute CVD (either when considering scores on the Holmes and Rahe Inventory or evaluation of serious SI). CONCLUSIONS: Psychosocial stress from SI does not seem to represent a RF in acute CVD.

Acute Disease↗
PubMed1996

[Validation of Allen's scale for the diagnosis of stroke].

INTRODUCTION: The importance of cerebrovascular pathology demands the most exact and complete diagnosis possible, by general physical and neurological examination and complementary techniques including computerized tomography (CT). Without CT, diagnosis may be delayed, for which reason such authors as Allen have put forward scales which by means of diagnostic scoring distinguish between stroke types. AIM: To validate the Allen scale as opposed to CT scan in a series of patients suffering from haemorrhagic and ischaemic stroke. MATERIALS AND METHOD: Sixty-two consecutive hospitalized patients suffering from stroke were studied, who all underwent CT scan within fifteen days of admission. RESULTS: The group consisted of 62 patients, 33 males (53%) and 29 females (47%) having an average of 70.2 +/- 11.2 years. The most frequent type of stroke was ischaemic (63%) as opposed to haemorrhagic (37%). Globally for all strokes we obtained the following results: Sensitivity (S) = 61%, Specificity (Sp) = 40%, positive predictive value ( + PV) = 84% and negative predictive value (-PV) = 17%. For ischaemic stroke the results were as follows: S = 76%, Sp = 66%; +PV = 67% and -PV = 76%. Finally for haemorrhagic stroke the results were S = 43%; Sp = 100%; +PV = 100% and -PV = 75%. CONCLUSIONS: The Allen scale has not proved to be a valid instrument in stroke diagnosis due to its low sensitivity and specificity especially in cases of haemorrhagic stroke.

Aged↗
PubMed1995

Arteriovenous fistulae complicating central venous catheterization: value of endovascular treatment based on a series of seven cases.

OBJECTIVES: To point out the usefulness and effication of endovascular treatment of arteriovenous fistulae complicating the insertion of central venous catheter. MATERIAL AND METHOD: Retrospective study of 7 cases treated between 1983 and 1993. The central venous catheterization had involved the right internal jugular vein in 5 cases and the right subclavian vein in 2 cases. RESULTS: Isolated endovascular therapy was performed in 5 cases. Surgery was necessary in 1 case to remove an hematoma. In another case, occlusion of a large AVF was performed during intraoperative endovascular temporary occlusion of the AVF. The choice of the occluding agent was primarily dictated by the hemodynamic and anatomical conditions (releasable balloons, coils). Vertebro-vertebral fistulae (3 cases) could be treated with patency of this vessel. No complications were encountered. CONCLUSION: Endovascular approach is a reliable and safe method to perform occlusion of post catheter AVF.

Adult↗
PubMed1994

[Percutaneous vertebral biopsy].

CT-guided vertebral biopsy is a simple, non dangerous, and usually an effective method for the actiological diagnosis and the treatment of vertebral lesions. The authors detail the biopsy technique, the needles and the route used according to the anatomical distribution and the osteosclerotic or osteolytic aspect of the vertebral lesion. In 60% of ordinary infectious spondylodiscitis the biopsy is positive. Early diagnosis of tuberculous spondylodiscitis is usually possible only to anatomopathological examination on osteodiscal samples. In tumoral disease the association of biopsy and cytological specimens provides the best results, specially in osteolytic vertebral lesions.

Biopsy, Needle↗
PubMed1993

Concentric MR patterns in multiple sclerosis. Report of two cases.

We report two cases of multiple sclerosis with concentric patterns of demyelinated foci on MR images. These were compared with the pathological data of Balò's disease. The T2-weighted MR images displayed alternating high and low signal areas which probably corresponded to the concentric type of demyelination. Our two cases were characterized by their acute onset and their regression following corticosteroid therapy. This suggests that Balò's disease may be a transient disease and not always associated with a fatal course.

Adult↗
PubMed1992

[Spontaneous complete rupture of the thoracic aorta. Apropos of a case surgically treated with success].

The authors report the case of a 74-year-old hypertensive man hospitalised with chest pain accompanied by shock and hemo-mediastinum. The diagnosis of spontaneous rupture of the thoracic aorta, suspected by aortic arteriography, was confirmed by thoracic CT scan with injection of contrast medium. Emergency surgery revealed a 4 cm longitudinal linear tear of the horizontal aorta, with neither dissection nor aneurysm. Simple suture during extra-corporeal circulation with normothermia and the heart beating, was successful after prolonged postoperative intensive care. This case of complete and spontaneous acute rupture of the horizontal thoracic aorta appears to be the first to have been successfully treated surgically.

Acute Disease↗
PubMed1991

Supraperiosteal lifting of the upper two-thirds of the face.

This paper presents an alternative to subperiosteal lifting (mask-lift), consisting in making the dissection following the natural plane of the sub-SMAS in the upper and middle thirds of the face. It constitutes what we have called supraperiosteal lifting of the upper two-thirds of the face, or suspension of the fronto-temporo-periorbito-malar SMAS. In our experience, this technique offers certain advantages and has fewer complications than subperiosteal lifting, allowing natural and harmonious rejuvenation of the upper two-thirds of the face, leaving no sequelae other than the coronal scar which is concealed in the scalp. The article describes the surgical procedure and the results obtained, as well as its frequent association with other procedures such as blepharoplasty, modification of the orbital bone rim, malar augmentation, rhinoplasty, cervicofacial lifting etc.

Adult↗
PubMed1988

Neurotization of the remaining latissimus dorsi muscle following muscle flap transplant.

The neurotization of the remaining latissimus dorsi muscle at the donor site is a useful technique in children. It is performed during the same surgical procedure as the free vascularized flap and consists of a neurolysis of the thoracodorsal nerve into three to five fascicles, and introducing them into three to five different openings in the muscle fibers. This technique is important in young patients for avoiding functional long-term sequelae such as scoliosis and developmental muscular defects of the vertebral column. Three cases are reported, with evaluation by electromyography and biopsy.

Adolescent↗
PubMedDate not supplied

[Surgical treatment of eyelid tumors].

Our surgical protocol for reconstruction of eyelid's defects after tumor excision is presented. Each technique is applied depending on the site and extension of the lesion and also on the pathologic characteristics of the tumor.

Eyelid Neoplasms↗
PubMedDate not supplied

[The assessment of neurological care needs in the health sector of de San Juan de Alicante by key-informants model].

BACKGROUND: Specific health care planning should be based on the care request according the most adjusted evaluations method. Data obtained from each geographic area may be most comparable with other from close areas. AIM: To determinate the neurological needs in the health area 16 of Valencian Community that includes the care corresponding to Hospital of San Juan de Alicante. MATERIAL AND METHOD: We conducted a survey among key informants using the primary care physicians of the area. The population of the healthy area is 144,781 people and includes 78 primary care physicians. We used the formula proposed by Kurtzke in 1982 in order to calculate the neurological time. RESULTS: We obtain a response rate of 82% the total number of neurological hours requested was 5,823.84 hours by year, which supposes a need of 8.82 neurologists by 100,000 people and nears a needs of 12.77 neurologists for the healthy area. These data are clearly higher that the obtained in other close areas using the same methodology (5 neurologists by 100,000 inh in Alcoi, 6 neurologists by 100,000 inh in the area corresponding to General Hospital of Alicante). The topics that require more than 100 hours by year are: migraine (1,205), lumbar backache (1,104), alcoholism (762), cranial trauma (442), deafness (285), stroke (272), seizures (181), disk herniation (166), cervical backache (140), zoster (162), psychosis (118), which supposes 83.12% of the whole neurological time. CONCLUSIONS: The data situated the area within a model of direct neurological care similar to that in the United States.

Health Planning↗