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Biomedical subjects

F M Lopez

Publications and source records attributed to F M Lopez.

At least 19 recordsLinked to original sources
PubMed2006

[Imaging of the diabetic foot].

Destruction in diabetic feet is secondary to neuropathy (peripheral and autonomic nervous system) in association with microangiopathy. The loss of sensation to pain and the static trouble lead to increase the pressure in some areas and predispose to pedal skin ulceration, the precursor of osteomyelitis. Plain radiography should be the first step in the evaluation for diagnosis and follow-up. The initial patterns are nonspecific but very rapid evolution associating osteolysis, osteosclerosis and fragmentation lead to the Charcot foot. When osteomyelitis is suspected, scintigraphy with labelled white blood cells and MRI are necessary to differentiate infection from neuropathy.

Diabetic Foot↗
PubMed2004

[Unilateral primary adrenal lymphoma: a case report].

The authors report a case of unilateral primary adrenal lymphoma presenting with abdominal and dorsal pain. Primary lymphoma of the genitourinary tract, specifically adrenal localisation, is a rare disease. CT is the current best imaging modality for evaluating retroperitoneal masses and improving detection, characterization as well as assessing extension. Diagnosis is based on histology.

Adrenal Gland Neoplasms↗
PubMed2000

Lower limb vein enlargement and spontaneous blood flow echogenicity are normal sonographic findings during pregnancy.

PURPOSE: We studied pregnancy-induced changes in lower limb venous function. METHODS: We used plethysmography and sonography to assess the changes in venous wall distensibility, saphenous vein diameters, and spontaneous blood flow echogenicity in the common femoral veins in 190 consecutive women during and after uncomplicated pregnancies (total of 409 examinations). RESULTS: The percentage of women with clinical symptoms and signs of venous insufficiency increased significantly during pregnancy. The mean diameters of the great and small saphenous veins also increased significantly, while occlusive venous plethysmography showed a decrease in parameters indicating vein distensibility. Spontaneous blood flow echogenicity in the common femoral veins was clearly visible or marked in 6% of cases during the first trimester of pregnancy, 63% during the second trimester, and 96% during the third trimester, versus 6% after delivery (p < 0.0001). The mean hematocrit decreased and the mean fibrinogen concentration increased during pregnancy. CONCLUSIONS: The increase in lower limb venous pressure seen during pregnancy leads to venous overdistention and worsens blood stasis. Decreased venous flow velocity and rheological alterations result in increased red cell aggregation, giving rise to spontaneous blood flow echogenicity. Spontaneous blood flow echogenicity is therefore a normal finding during pregnancy and should not be mistaken for venous thrombosis.

Adult↗
PubMed1998

Medial canthus single-injection episcleral (sub-tenon anesthesia): computed tomography imaging.

UNLABELLED: Single-injection medial canthus periocular anesthesia is a promising regional anesthesia technique for ophthalmic surgery. The purpose of this computed tomography (CT) study was to confirm that this technique is an episcleral injection and to explain why it provides a good akinesia of the globe. Four fresh nonpreserved cadavers (eight eyes) were injected with fractioned various volumes of a contrast media using a previously described technique. For each injection and each eye, CT scans were performed in three planes of the space, and the site and spread of the injection was observed. We confirm that single-injection medial canthus periocular anesthesia is, in fact, an episcleral anesthesia, which explains the good sensory block of the globe. When larger volumes are injected, the contrast media spreads to the lids and extraocular muscle sheaths. We believe that this may explain why this technique provides good sensory and motor block of the globe and eyelids. This technique is a promising alternative to both retro- and peribulbar anesthesia. IMPLICATIONS: We describe medial canthus single-injection periocular anesthesia by a computed tomography injection study in eight human cadaver eyes. It was confirmed to be an episcleral injection. Akinesia of the eyeball is provided by spreading of the local anesthetic solution from the episcleral space to the rectus muscle sheaths.

Anesthesia, Conduction↗
PubMed1997

[Contribution of imaging in closed thoracic trauma].

Conventional or digital chest radiographs are usually efficient for diagnosis of minor chest trauma. The primary modality for diagnostic evaluation of severe blunt chest trauma remains chest X-ray. Other imaging modalities especially CT have to be performed. The management of these patients is based upon clinical and initial radiographic findings.

Adolescent↗
PubMed1997

Diagnosis of acute lower limb deep venous thrombosis with ultrasound: trends and controversies.

Acute deep venous thrombosis of the lower limb is a common and threatening condition whose clinical diagnosis is known to be unreliable. Sonography has gradually superseded venography as the primary diagnostic procedure. A review of the medical literature shows that sonography offers a high level of sensitivity and specificity in symptomatic patients but suffers from a lack of sensitivity at the calf level and in asymptomatic patients. Technologic progress, as well as increased operator experience, may improve sensitivity. Nevertheless, several critical issues remain unresolved, such as the significance of free-floating thrombi, the usefulness of calf and bilateral examination, the criteria that are essential to the diagnosis, the risk of compression sonography, and sonography's role in the direct detection of venous emboli.

Acute Disease↗
PubMed1997

[Diaphragm kinetics coupled with spirometry. M-mode ultrasonographic and fluoroscopic study; preliminary results].

Most techniques used so far for the evaluation of diaphragm kinetics are either invasive (electromyography, fluoroscopy), or indirect (respiratory pressures, impedance plethysmography). The aim of this study was to determine whether assessment with ultrasound or fluoroscopy differed, and which technique appeared more suitable in the investigation of quantitative hemidiaphragmatic displacement. Six patients (3 female, 3 male, aged 29 to 40) without respiratory disease were studied during systematic X-Ray chest examination, spirometry, and abdominal sonography. The amplitude of the right diaphragm motion could be measured in all patients with M-mode sonography as well as with fluoroscopy. The vertical ascending motion of the diaphragm measured by M-mode sonography, reached 60% of its maximum amplitude at 50% of inspiratory capacity. There was a significant correlation between the maximum amplitude of diaphragm motion as measured by M-mode sonography (5.8 +/- 0.4 cm; r = 0.89; p = 0.019) or fluoroscopy (5.6 +/- 0.7 cm; r = 0.84; p = 0.036) and the inspiratory capacity (2.73 +/- 0.39 l). M-mode sonography has technical, quantitative and qualitative advantages over fluoroscopy and should be the method of choice in the investigation of suspected diaphragmatic movement disorder. When coupled with other techniques like spirometry, this technique could represent a useful adjunct to functional respiratory studies.

Adult↗
PubMed1996

Accurate measurement of impaired glomerular filtration using single-dose oral cimetidine.

To improve the validity of a timed creatinine clearance as a measure of glomerular filtration rate (GFR), we investigated whether a single 800-mg dose of oral cimetidine was sufficient to inhibit tubular secretion of creatinine (TScr). Forty-five 3-hour timed creatinine clearances (Clcr) with single 800-mg dose oral cimetidine (TCC) in 17 renal transplant recipients with marked renal function impairment (creatinine 2.0 to 7.1 mg/dL) were compared with simultaneous [125I]-iothalamate GFR (Cliothal). For comparison, 13 timed Clcr without cimetidine (TC), and 36 24-hour Clcr were performed. The TCC was the most accurate: the ratio (mean +/- SD) of TCC:Cliothal was 1.12 +/- 0.02, compared with 1.33 +/- 0.08 for Clcr:Cliothal and 1.53 +/- 1.02 for TC:Cliothal. The difference between Cliothal and TCC was small over the range of GFRs tested (mean +/- 2 SD), 0.9 +/- 2.5 mL/min/1.73 m2. The intraclass correlation (R) for within-subject reproducibility of the TCC in five subjects was 0.8 (95 percent CI; 0.5, 0.9), and in 11 subjects who had at least three GFR determinations over 24 weeks, the TCC was as responsive to change in GFR as Cliothal. There was an inverse relationship between fractional excretion of cimetidine and GFR (r2 = -0.70), suggesting increased tubular secretion of cimetidine with decreasing GFR. In conclusion, a single 800-mg oral dose of cimetidine was effective in inhibiting TScr such that the TCC was an accurate, reproducible, and responsive test of GFR.

Administration, Oral↗
PubMed1994

Tubal sterilization by selective catheterization in an animal model.

RATIONAL AND OBJECTIVES: The feasibility of tubal occlusion by selective salpingography was tested in an animal model; three novel occluding materials also were tested for this application. METHODS: Unilateral selective salpingography was performed in three groups of six rabbits; fallopian tubes were embolized with ethanol (group 1), a hydrogel (group 2), or an occluding emulsion (Ethibloc, Laboratoire Princeps, Neuilly sur Seine, France) (group 3). Animals were killed 2 days or 30 days after the procedure, according to randomization; tubal patency and histologic modifications were evaluated. RESULTS: Selective tubal catheterization was obtained in 100% of the cases. In group 1, no satisfactory occlusion was obtained; in group 2, 65% of the tubes were occluded with little histologic damage; in group 3, 80% of the tubes were occluded, but significant inflammation and tissue necrosis were noted. CONCLUSION: Selective salpingography proved a suitable method for gaining access to the fallopian tube and allowed selective injection of occluding materials. More research is needed to determine a suitable occluding material, focusing on biocompatibility and on long-term efficacy.

Animals↗
PubMed1993

Focal myositis: a localized form of polymyositis?

We describe an additional case of focal myositis presenting as a painful pseudotumor of the lower leg. Surgical biopsy showed typical features of myositis; the disease improved spontaneously, without clinical or biological abnormalities. Focal myositis can remain a localized process, but in some cases it can become an authentic polymyositis. These generalized forms are associated early with elevated erythrocyte sedimentation rate and/or muscular enzymes.

Adult↗
PubMed1993

[Cerebral thrombophlebitis disclosing Behçet disease. Value of high resolution MRI].

A 21-year-old male of Moroccan descent was admitted for inflammatory polyarthralgia and monoarthritis of the left knee. The patient reported a history of recurrent isolated aphthous ulcerations of the oral cavity. He was found to be positive for the HLA B5 antigen. The other investigations for Behçet's disease were negative. During hospitalization, headache responsible for insomnia developed. Neurologic evaluation was normal, as well as funduscopy and spinal tap findings. CT scan images were suggestive of cerebral thrombophlebitis. Magnetic resonance imaging (MRI) disclosed an old thrombosis of the right transverse sinus. Time-of-flight MRI (MRI with sequences adapted to the study of vessels) evidenced recent thrombophlebitis of the left transverse sinus. Cerebral angiography fully confirmed MRI findings. Treatment with a corticosteroid and an anticoagulant was successful. Final diagnosis was Behçet's disease. Subsequently, the patient developed additional features of the disease, including hypersensitivity to pinprick, retinal vasculitis, and erythema nodosum. This case is interesting for two reasons: cerebral thrombophlebitis in Behçet's disease can manifest as localized headache. It occurs in 6 to 13% of patients. Early diagnosis and treatment are essential; MRI features of cerebral thrombophlebitis were confirmed by the cerebral angiogram. MRI established that the thrombophlebitis was of recent onset. MRI may be appropriate as the initial investigation in patients with suspected cerebral thrombophlebitis.

Adult↗
PubMed1993

[Pulsatile vaginal expansion: Case report of an internal iliac aneurysm detected after an injury].

After a pelvic trauma, in a 78 years old women, systematic radiograms showed a polycyclic mass in the left side of the pelvis. This finding was confirmed by B-mode ultrasound echography. The vaginal touch found a pulsatile and expanding mass. At surgery, the diagnosis of a fissuring aneurysm of the internal iliac artery was confirmed, and a curative treatment was undertaken. Reviewing the literature, the authors emphasize the diagnostic usefulness of rectal and vaginal touch, and the importance of an early diagnosis using noninvasive imaging techniques. Surgery is the only treatment for isolated internal iliac aneurysms.

Aged↗
PubMed1993

[Lipomatous hypertrophy of the interatrial septum. Apropos of 3 cases and review of the literature].

Lipomatous hypertrophy of the interatrial septum is characterised by an accumulation of fatty tissue in the interatrial septum. The authors report three cases, one presenting with sinus tachycardia and the other two being chance findings. Echocardiography associated with cardiac computerised tomography or magnetic resonance imaging usually confirms the diagnosis. In half the cases, supraventricular arrhythmias and suggestive P wave abnormalities are observed on the electrocardiogram. The diagnostic value of transoesophageal echocardiography is emphasised; it demonstrates the massive forms which may obstruct flow from the superior vena cava into the right atrium. The authors observe a discrepancy between the prevalence of this condition in autopsy series (about 1%) and the small number of cases described at echocardiography, suggesting that the diagnosis is probably missed.

Aged↗
PubMed1993

Portal hypertension in lymphoproliferative and myeloproliferative disorders: hemodynamic and histological correlations.

The pathogenesis of portal hypertension in patients with lymphoproliferative and myeloproliferative disorders is not fully understood. We investigated 20 patients with myeloproliferative disease and 47 patients with lymphoproliferative disease. Transvenous liver biopsies and hepatic vein pressure gradient measurements were performed in all patients, and portal vein blood flow was measured by pulsed Doppler sonography in 31 of these patients and in 22 normal volunteers. The hepatic vein pressure gradient was significantly higher in patients with hepatic infiltrates, fibrosis or both than in patients without hepatic lesions (8.3 +/- 5.0 mmHg vs. 4.1 +/- 2.3 mmHg; p < 0.01). Portal vein blood flow was significantly higher in patients with hematological disease than in normal volunteers (31.2 +/- 15.5 ml/min.kg vs. 14.2 +/- 4.6 ml/min.kg;p < 0.01). In 81.8% of patients with hepatic infiltrates, fibrosis or both and increased portal vein blood flow, the hepatic vein pressure gradient was greater than 6 mm Hg. Although we saw a significant correlation between splenic vein blood flow and portal vein blood flow (n = 20; p < 0.01), we found no significant correlation between splenic vein blood flow and hepatic vein pressure gradient or spleen size. Hepatic infiltration and fibrosis appear to be major determinants of increased hepatic vein pressure gradient, probably because they increase intrahepatic vascular resistance. The role of increased splenic blood flow is probably not determinant. However, because portal pressure was not measured directly in this study, the incidence of portal hypertension may have been underestimated.

Adult↗