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Biomedical subjects

F G Gallardo

Publications and source records attributed to F G Gallardo.

11 recordsLinked to original sources

[Osteitis in secondary syphilis].

BACKGROUND: The aim of this study is to report two patients with osteitis in secondary syphilis. The increase in the number of cases of syphilis, linked to the changes in sexual behavior and to the increase of immigrants from areas of high prevalence of STD, as well as its relationship with HIV infection, makes important to clinicians become aware of unusual presentation of secondary syphilis. PATIENTS: We report two patients diagnosed of secondary syphilis, one of them with HIV infection. Both showed dermatological lesions in palms and soles, malaise and fever. Bone scintigraphy showed significant uptake in parietal and frontal bones in both patients. Clinical response was quickly achieved after penicillin treatment. CONCLUSIONS: In patients with secondary syphilis and osteoarticular symptoms luetic osteitis must be included in differential diagnosis. Bone scintigraphy should be the first diagnostic tool because it possibilities to perform a total body scan which allows localizing asymptomatic lesions. Moreover bone scan shows a high sensitivity.

Adult↗

[Brain SPECT with 201-thallium in AIDS patients].

UNLABELLED: Brain lymphoma is a late complication in AIDS. Lymphoma incidence is increasing in AIDS patients due to the introduction of HAART and prolongation of these patients' life expectancy. This work aims to evaluate the usefulness of brain SPECT with 201Tl in patients with AIDS who present focal brain lesions in computed tomography (CT). METHODS: Seventeen patients with neurologic symptoms and focal neurologic lesions in the CNS (central nervous system) were studied. The images were interpreted as positive when the intensity of the focal deposit of the tracer was greater than that of the adjacent tissue. The SPECT results were compared with serologic data, clinical evolution and/or radiologic follow-up and cerebral biopsy. RESULTS: SPECT images showed focal uptake of radiotracer in 3 patients. All three died shortly after the SPECT was performed. All of them had negative serology for toxoplasmosis. Four patients were diagnosed of progressive multifocal leukoencephalopathy and the ten remaining cases had a good clinical and/or radiologic response. CONCLUSIONS: Brain SPECT with 201Tl is a very useful non-invasive technique for the differential diagnosis of cerebral focal lesions in AIDS patients.

Adult↗

[Gallium-67 (Ga-67) scintigraphy in tuberculosis and Mycobacterium avium-M. intracellulare infections in patients with HIV infections].

BACKGROUND: Diagnosis of mycobacterioses in HIV infected patients is sometimes difficult because of atypical findings. The aim of this study was to assess the utility of gallium scintigraphy in diagnosis of AIDS related mycobacterioses in patients with fever of unknown origin. PATIENTS AND METHODS: We retrospectively reviewed the scans of 220 HIV(+) patients with fever (176 males [80%] and 44 females) who were evaluated with conventional diagnostic procedures at least of a week before. RESULTS: Gallium scintigraphy was positive in 114 patients (51%) and negative in 106 (49%). Mycobacteria were isolated in 83 patients (38%), 75 of these patients (90%) had a positive scintigraphy (sensitivity 90%; specificity 71%). Positive predictive value was 66% and negative predictive value was 92%. Mycobacterium avium-M. intracellulare (MAI) and M. tuberculosis were diagnosed in 22 (29%) and 53 (71%) HIV(+) patients, respectively. Seventy one (94%) of 75 patients with mycobacterioses had gallium uptake in at least two localizations. CONCLUSIONS: 67Ga scintigraphy is very useful in HIV(+) patients with fever of unknown origin. A negative gallium scintigraphy makes unlikely the diagnosis of mycobacterioses.

AIDS-Related Opportunistic Infections↗

Identification of AIDS-related tuberculosis with concordant gallium-67 and three-hour delayed thallium-201 scintigraphy.

Concordant gallium-67 and thallium-201 uptake has been described in malignant lesions. More recently, 201Tl accumulation has been described in some benign conditions. The authors report three HIV-positive patients who underwent 67Ga and 201Tl scintigraphy. These studies revealed concordant 67Ga and 201Tl uptake and tumour was erroneously diagnosed. All three patients were finally diagnosed as having tuberculosis.

AIDS-Related Opportunistic Infections↗

Abnormal gallium-67 skull uptake: a sign of peripheral marrow activation in HIV-positive patients with disseminated mycobacterioses.

UNLABELLED: The purpose of this study was to investigate the significance of abnormal 67Ga-citrate skull uptake in AIDS patients with mycobacterioses. METHODS: Gallium-67 scans of 39 HIV-positive patients who have been diagnosed with mycobacterioses were analyzed; the scans of 15 consecutive HIV-positive patients without mycobacterioses were also reviewed as a control group. The skull was chosen to assess bone marrow uptake because of the absence of overlapping structures. RESULTS: Twenty-nine of 39 (74%) patients with mycobacterial infections had disseminated disease. Gallium-67 uptake in the skull was visualized in 24 of these 29 patients (82%). One of the patients without disseminated disease and one patient in the control group (n = 15) showed skull uptake. CONCLUSION: Abnormal 67Ga skull uptake appears to be a sensitive (82%) and specific (82%) indicator of disseminated mycobacterial infection in HIV-positive patients.

AIDS-Related Opportunistic Infections↗

[Silent ischemia versus angina in Tl-201 tomoscintigraphy].

INTRODUCTION: The aim of this work was to describe the variables associated to silent ischemia in patients with reversible perfusion defects in poststress myocardial perfusion scintigraphy. METHODS: Tl-201 myocardial perfusion SPECT of 522 patients showing total or partially reversible perfusion defects after exercise testing were quantitatively analyzed retrospectively. Relationship between silent ischemia, size of perfusion defect and presence of risk factors was performed. RESULTS: Ischemia was silent in 412 (73 %) patients. In 176 (33 %) patients exercise test was electrically positive. There were no differences in perfusion defect size between patients with and without angina in exercise test (27 +/- 12 vs 27 +/- 14), but patients with angina had a greater degree of reversibility, in left descending artery (LDA) territory (56 +/- 40 vs 45 +/- 40 p < 0.01). Silent ischemia was more frequently observed in patients with previous acute myocardial infarction (46 % vs 35 %). There was no relationship between the production of exertional angina and the presence of risk factors. CONCLUSIONS: A high number of patients with reversible perfusion defects on SPECT had silent ischemia. Patients with angina during exercise test had more defect reversibility in LDA territory. Silent ischemia is more frequent in patients with previous acute myocardial infarction.

Aged↗

[Hyperemic reactivity scintigraphy in endothelial function].

OBJECTIVE: The aim of this study was to compare a recently described method to evaluate endothelial function; the hyperemic reactivity scintigraphy (HRS) with the ultrasonographic flow-mediated dilatation (FMD) in brachial artery and its relationship with myocardial SPECT. METHODS: 42 consecutive patients that underwent myocardial scintigraphy were included. Thirty-six patients had simultaneous measurement of FMD. Both studies were obtained after 5 minutes occlusion of the upper arm with a blood pressure cuff inflated at 250 mmHg. HRS was performed dynamically at rate 1 frame/sec during 3 minutes after intravenous injection of 740 MBq of Tc-99 sestamibi. Time-activity curves allowed obtaining the following indexes: medium hyperemic activity/medium contrallateral activity (MHA/MCA) and maximum hyperemic activity/maximum contrallateral activity (MxHA/CxHA). RESULTS: In 13 patients SPECT was normal. Twenty-nine patients had perfusion defects in scintigraphy. There was relationship between the FMD and the MHA/MCA (r = 0.23; p = 0.018) and the FMD and the MxHA/CxHA (r = 0.18; p = 0.05). Patients with alterations in the SPECT had an index MxHA/CxHA lower than patients with normal SPECT (1.8 +/- 0.2 vs 1.5 +/- 0.4; p = 0.04). We did not find relationship between FMD and alterations in SPECT. CONCLUSIONS: There is relationship between FMD and HRS. HRS is lower in patients with perfusion defects in the SPECT. HRS could provide additional value to myocardial scintigraphy.

Aged↗