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Biomedical subjects

I Muñoz

Publications and source records attributed to I Muñoz.

At least 19 recordsLinked to original sources
PubMed2007

Effect of lighting stress on fluctuating asymmetry, heterophil-to-lymphocyte ratio, and tonic immobility duration in eleven breeds of chickens.

The purpose of the present study was to analyze the effect of a lighting stress on the fluctuating asymmetry (FA), the heterophil-to-lymphocyte ratio, and the tonic immobility duration of chickens. The experiment (440 birds) measured the FA of several traits (outer, middle, inner, and hind toe lengths and leg, wing, second primary feather, and spur lengths), the heterophil-to-lymphocyte ratio, and the tonic immobility duration in 36-wk-old hens and cocks of 8 Spanish breeds of chickens (Black-Barred Andaluza, Black-Red Andaluza, Black Castellana, Buff Prat, Red-Barred Vasca, Red Villafranquina, Birchen Leonesa, and Blue Leonesa), a synthetic breed (Quail Castellana), a White Leghorn population, and the e(y) tester line, which had been housed in continuous light (24L:0D) or in a light-dark regimen (14L:10D) for 16 wk. There was a significant difference between lighting treatments in both females and males on the combined FA of the 4 toes (P < 0.01) and the combined FA of toe, leg, wing, feather, and spur (in males) lengths (P < 0.05), the FA of birds housed under continuous light being greater than that of control birds. There was a significant difference (P < 0.001) for the heterophil-to-lymphocyte ratio and the tonic immobility duration between lighting treatments, the ratio being higher and the duration being longer in the group of birds housed under continuous light. Thus, birds exposed to continuous light were more stressed and fearful than control hens. Results were consistent across the breeds and indicate that a continuous light regimen seriously negatively affects the welfare of birds.

Animals↗
PubMed2005

Prophylaxis of early bacterial infections after autologous peripheral blood stem cell transplantation (PBSCT): a matched-pair study comparing oral fluoroquinolones and intravenous piperacillin-tazobactam.

The safety and efficacy of early bacterial prophylaxis with piperacillin-tazobactam were prospectively evaluated in 51 autologous peripheral blood stem cell transplantation (PBSCT) recipients. The results were compared with those obtained in 51 control patients receiving oral fluoroquinolones in a retrospective matched-pair control study. Overall, 76% of the study group and 98% of the control group developed at least one febrile episode during neutropenia (P=0.002). Time from neutropenia to the first febrile episode (FFE) was significantly longer in the study group than in the control group (P=0.04). Once a febrile episode appeared, the duration of fever was significantly longer in cases than in controls (median of 5 and 2 days respectively, P<0.001), and led to a more frequent use of empirical amphotericin B (AmB), not statistically significant (P=0.13). However, the total time of antibiotic administration was significantly greater in the control than in the study group (P=0.05). The duration of AmB treatment shows a trend toward a longer duration in the control than in study group (P=0.2). Overall, 86% of the Gram-positive bacteremia and 85% of the Gram-negative bacteria were susceptible to the tested antibiotics. Our study suggests that a subgroup of patients could benefit from prophylaxis with piperacillin-tazobactam without increasing toxicity or bacterial resistance.

Adolescent↗
PubMed2005

Estimation of heritability for fluctuating asymmetry in chickens by restricted maximum likelihood. Effects of age and sex.

The purposes of the present study were to estimate the heritability of the fluctuating asymmetry in chickens, using the restricted maximum likelihood procedure, and to evaluate the effects of age and sex on the fluctuating asymmetry. Leg, wing, and feather lengths and ear-lobe and wattle areas were measured. In experiment 1, 1,073 birds were used from 2 generations with complete pedigree of the Quail Castellana breed to estimate the heritability for the fluctuating asymmetry at 36 wk of age. The estimated heritability of absolute fluctuating asymmetry was not significantly different from zero for all 5 traits, and similar estimates were obtained for relative fluctuating asymmetry, directional asymmetry, transformed absolute and relative fluctuating asymmetry, and 3 alternative indexes of fluctuating asymmetry. The heritability of the combined absolute or relative fluctuating asymmetry was still very low, indicating that fluctuating asymmetry was determined solely by environmental sources of variation and that fluctuating asymmetry estimates should not be confounded by appreciable additive genetic contributions. The genetic correlation between sides was not significantly different from one, indicating that differences between sides were purely environmental in origin. Different traits rarely showed much correlation in their level of fluctuating asymmetry, indicating that the level of fluctuating asymmetry in all traits did not reflect equally the quality of animals. In experiment 2, fluctuating asymmetry differences among ages and sexes were investigated at 8, 12, 16, 20, 24, 28, 32, 36, and 40 wk in 360 birds from the same breed. Significant variation with age was observed in leg length, wing length, feather length (females), and wattle area (females), which was mainly related to onset of sexual maturity and adult stage. Females showed significantly greater fluctuating asymmetry for ear-lobe area than males. There were significant differences in fluctuating asymmetry for wing length, feather length, and wattle area near the onset of sexual maturity, with males having significantly greater fluctuating asymmetry than females for wing length and the opposite being true for feather length and wattle area.

Aging↗
PubMed2005

Influence of perches and footpad dermatitis on tonic immobility and heterophil to lymphocyte ratio of chickens.

The purpose of the present study was to analyze the effect of perches and footpad dermatitis on stress and fear levels of chickens. In experiment 1 heterophil to lymphocyte ratio and tonic immobility duration were measured in 36-wk-old hens (36 birds) from 2 Spanish breeds of chickens (Black Menorca and Quail Castellana) housed in pens with or without perches from 20 wk of age. There was a significant difference in the heterophil to lymphocyte ratio between perch treatments (P < 0.05), the ratio of hens with perches being lower than that of hens without perches. Hens with perches had significant lymphophilia (P < 0.05). There was no significant difference for the duration of tonic immobility between hens with or without perches. Thus, hens with perches were less stressed than hens without perches, as indicated by the heterophil to lymphocyte ratio. Heterophil to lymphocyte ratio and heterophil number for Black Menorcas were significantly smaller (P < 0.001) than for Quail Castellanas, whereas lymphocyte number was greater in Black Menorcas. The Black Menorca hens had significantly (P < 0.01) shorter tonic immobility duration. In experiment 2 heterophil to lymphocyte ratio and tonic immobility duration were measured in 52-wk-old cocks (36 birds) of each of two different Spanish breeds of chickens (Black Barred Andaluza and Red Barred Vasca) housed in cages from 36 wk of age and showing or not showing footpad dermatitis. There was no significant effect of footpad dermatitis on the heterophil to lymphocyte ratio, its numerator, or its denominator, whereas there was significant effect on tonic immobility duration (P < 0.05) with tonic immobility of cocks with footpad dermatitis being longer than that of cocks without footpads. Thus, cocks with footpad dermatitis were more fearful than cocks without footpad dermatitis, as indicated by the tonic immobility duration. Heterophil to lymphocyte ratio and heterophil number were significantly smaller (P < 0.05) for Black Barred Andaluzas than for the Red Barred Vascas.

Animals↗
PubMed2004

Nuisance odours produced by benthic cyanobacteria in a Mediterranean river.

Geosmin dynamics in the Llobregat waters were related to the waxing and waning of benthic cyanobacterial mats developing in the river. Geosmin concentration in the water during 2002 reached a maximum of 204 ng L(-1), and coincided with an abundance of cyanobacteria in the river. Cyanobacterial mats were favoured by the high nutrient content of the waters. The cyanobacterial mats experienced a process of growth in thickness (attached forms), until they became unattached and drifted downstream (free-floating forms), accumulating in shallow areas of the river. Geosmin in the biofilm ranged from 0.55 +/- 0.97 ng geosmin per mg DW(-1) in the attached biofilms and 5.25 +/- 4.96 ng geosmin per mg DW(-1) in the free-floating biofilms. While the attached mats could be responsible for the local occurrence of geosmin at a given site, the free-floating mats became a relevant agent for the dispersion of the metabolite downstream. This impression was reinforced by the extremely high correlation between the geosmin content in the free-floating biofilm and in the water (r = 0.917, p = 0.00001). In order to reduce the geosmin concentration and accumulation of the cyanobacterial mats in shallow river waters, the nutrient content should be controlled and the natural flow conditions restored, to prevent the growth and accumulation of the geosmin-producing cyanobacterial mats.

Cyanobacteria↗
PubMed2003

Biofilm structure and function and possible implications for riverine DOC dynamics.

Biofilms are major sites of carbon cycling in streams and rivers. Here we elucidate the relationship between biofilm structure and function and river DOC dynamics. Metabolism (extracellular enzymatic activity) and structure (algae, bacteria, C/N content) of light-grown (in an open channel) and dark-grown (in a dark pipe) biofilms were studied over a year, and variations in dissolved organic carbon (DOC) and biodegradable DOC (BDOC) were also recorded. A laboratory experiment on 14C-glucose uptake and DOC dynamics was also performed by incubating natural biofilms in microcosms. On the basis of our field (annual DOC budget) and laboratory results, we conclude that light-grown biofilm is, on annual average, a net DOC consumer. This biofilm showed a high monthly variability in DOC uptake/release rates, but, on average, the annual uptake rate was greater than that of the dark-grown biofilm. The higher algal biomass and greater structure of the light-grown biofilm may enhance the development of the bacterial community (bacterial biomass and activity) and microbial heterotrophic activity. In addition, the light-grown biofilm may promote abiotic adsorption because of the development of a polysaccharide matrix. In contrast, the dark-grown biofilm is highly dependent on the amount and quality of organic matter that enters the system and is more efficient in the uptake of labile molecules (higher 14C-glucose uptake rate per mgC). The positive relationships between the extracellular enzymatic activity of biofilm and DOC and BDOC content in flowing water indicate that biofilm metabolism contributes to DOC dynamics in fluvial systems. Our results show that short-term fluvial DOC dynamics is mainly due to the use and recycling of the more labile molecules. At the river ecosystem level, the potential surface area for biofilm formation and the quantity and quality of available organic carbon might determine the effects of biofilm function on DOC dynamics.

Analysis of Variance↗
PubMed2001

Effects of atrazine on periphyton under grazing pressure.

An experiment was carried out using indoor experimental channels to assess the long-term effect (18 days) of herbivores (Physella acuta, Gastropoda) on periphyton communities exposed to low levels of atrazine (14 microg l(-1)). We hypothesized that herbivorism modifies the response of periphyton to atrazine. Carbon incorporation, chlorophyll-a content, biovolume and algal taxonomic composition in the channels that contained atrazine were not significantly different from the control channels (not receiving atrazine). In channels with grazers and atrazine, there was a significant reduction of carbon incorporation and algal density. In this treatment, physiognomic forms and algal composition were significantly different from the others. The biomass of grazers (measured as change in dry mass) was not significantly affected by the addition of atrazine. Grazers maintained low levels of periphyton biomass, enhancing algal cell exposition to toxicant and inhibiting any adaptation of the algae to the toxic exposure. The increase in atrazine toxicity with grazing not only affected the metabolism, but also the structure of the algal community, which suggests that effects were not transient but permanent.

Animals↗
PubMed2001

Qualitative plasma PCR assay (AMPLICOR CMV test) versus pp65 antigenemia assay for monitoring cytomegalovirus viremia and guiding preemptive ganciclovir therapy in allogeneic stem cell transplantation.

The performances of a commercially available qualitative plasma PCR assay (AMPLICOR CMV test; Roche Diagnostics) and the pp65 antigenemia assay (AG) were evaluated for the monitoring of cytomegalovirus (CMV) viremia in 43 allogeneic stem cell transplant recipients. In addition, the suitabilities of both assays for triggering the initiation of preemptive ganciclovir therapy were assessed. A total of 37 CMV viremic episodes were detected in 28 patients. Positivity of plasma PCR testing in one or more consecutive specimens was the only marker of CMV viremia in 18 of the 37 episodes (PCR positive and AG negative, n = 50 specimens). Five episodes were diagnosed on the basis of a single positive AG result (AG positive and PCR negative, n = 5 specimens); both assays were eventually positive (PCR positive and AG positive, n = 27 specimens) for 14 viremic episodes; for these episodes, conversion of the PCR assay result to a positive result occurred an average of 1 week before conversion of the AG result. Overall, the concordance between the two methods was 90%, and the sensitivities of the plasma PCR assay and AG for the detection of CMV viremic episodes were 86.5 and 51.3%, respectively. Two patients who tested positive by both assays simultaneously progressed to CMV end-stage organ disease, despite the initiation of preemptive ganciclovir therapy. Conversion of the AG result to a negative result upon administration of preemptive ganciclovir therapy occurred a median of 7.5 days earlier than conversion of the plasma PCR assay result. Nineteen of the 28 patients with CMV viremia received AG-guided preemptive ganciclovir therapy; had the positivity of the plasma PCR assay triggered the initiation of preemptive therapy, 9 additional patients would have been unnecessarily treated since none of them developed CMV end-stage organ disease. Although the AMPLICOR CMV assay is more sensitive than AG, the latter appears to be more suitable both for guiding the initiation of preemptive therapy and for monitoring a patient's response to antiviral therapy.

Antiviral Agents↗
PubMed2001

Left ventricular remodeling after pulmonary autograft replacement of the aortic valve (Ross operation).

BACKGROUND AND AIM OF THE STUDY: Aortic valve replacement (AVR) with a pulmonary autograft is an alternative treatment for young patients with aortic valve disease. Superior hemodynamic performance of the pulmonary autograft, and impact on parameters of left ventricular function were analyzed. METHODS: Thirty patients (21 males, nine females; mean age 29.97+/-12.29 years; range: 6-54 years) underwent a Ross procedure between November 1997 and November 1999. Seven patients (23%) were children (aged <15 years). In total, 22 patients were analyzed; each had at least three months follow up. Eleven patients had predominant aortic stenosis (AS), and 11 had aortic insufficiency (AI). RESULTS: There were no operative deaths. Two patients developed severe insufficiency, and the autograft was replaced with a mechanical valve. Pre- and postoperative echocardiograms were reviewed. The mean neoaortic maximal gradient was 7.85+/-5.59 mmHg (range: 3-29 mmHg). AS patients showed reduced interventricular septal (IVS) thickness at one month (from 13.27+/-3.69 to 11.60+/-2.44 mm; p = 0.0165) and 18 months after surgery (p = 0.0104). Left ventricular posterior wall (LVPW) thickness was reduced from 12.04+/-3.75 to 9.48+/-2.47 mm (p = 0.0338) at one month and 18 months (p= 0.0128) after surgery. The left ventricular end-diastolic internal dimension (LVIDd) decreased from 50.71+/-10.20 to 44.98+/-7.29 mm (p = 0.0491) at one month after surgery. In AI patients, LVPW and IVS thicknesses showed no significant variation, and LVIDd was decreased at one month (from 68.50+/-8.39 to 59.04+/-9.21 mm; p = 0.0017) and 18 months (p = 0.0229) after surgery. Left ventricular end-systolic internal dimension (LVIDs) decreased from 44.06+/-6.39 to 39.03+/-7.99 mm (p = 0.0081) at three months after surgery. Left ventricular mass index (LVMI) in the AS group decreased from 179.01+/-62.26 to 115.74+/-37.62 g/m2 (p = 0.0021) at one month after surgery, and at 18 months was normal, with a decrease from 208.77+/-32.89 to 95.89+/-28.82 g/m2 (p= 0.0003) (n = 5). In the AI group, LVMI decreased from 186.25+/-85.21 to 140.58+/-62.02 g/m2 (p = 0.0011) at one month after surgery, and at 18 months from 217.70+/-98.02 to 146.73+/-84.55 g/m2 (p= 0.0131) (n = 5). CONCLUSION: The pulmonary autograft procedure can be used safely to replace the aortic valve, and allows optimal hemodynamic performance, with no significant aortic regurgitation. The Ross procedure results in normalization of left ventricular dimensions and improvement of left ventricular function early in the postoperative period.

Adolescent↗
PubMed2001

Lack of association between the kinetics of human cytomegalovirus (HCMV) glycoprotein B (gB)-specific and neutralizing serum antibodies and development or recovery from HCMV active infection in patients undergoing allogeneic stem cell transplant.

The kinetics of the gB-specific and neutralizing antibody responses to human cytomegalovirus (HCMV) were analyzed in 26 allogeneic stem-cell transplant recipients who either did (n = 20) or did not (n = 6) develop asymptomatic HCMV active infection during the study period. Antibody response profiles varied widely among individuals in both groups, irrespective of whether HCMV active infection did or did not occur. Development of HCMV active infection was not preceded by a decline in functional serum antibody levels. Neither the absence nor the presence of HCMV active infection correlated with either high or low serum levels of gB-specific and neutralizing antibodies, respectively. In most patients, episodes of HCMV replication were not followed by a marked increment in functional serum antibody titers. Therefore, resolution of an ongoing HCMV active infection was not associated with a vigorous antibody response to viral replication. In addition, this study supports previous data indicating that passive transfer of human immunoglobulins may result in an increment in gB-specific and neutralizing serum antibody levels, the magnitude of which varies among recipients; however, both patients with and without measurable increments in serum antibody levels developed HCMV active infections with comparable frequency.

Adult↗
PubMed2001

Behavior of the pulmonary autograft in systemic circulation after the Ross procedure.

OBJECTIVE: The purpose of this study was to evaluate performance in systemic circulation following pulmonary autograft aortic root replacement by means of serial postoperative echocardiographic studies. METHODS: From November 1997 to November 1999, 30 patients (21 males, 9 females) with a mean age of 29.97 +/- 12.97 years (age range 6-54 years) underwent pulmonary autograft aortic root replacement. Seven of these patients (23.33%) were less than 15 years old. Postoperative echocardiographic measurements of the neo-aortic root were performed within three months of operation, at six months, one year, and annually thereafter. Analysis of this study includes 22 patients with at least three months of follow-up. RESULTS: Operative mortality was 0%. Compared with preoperative values, the mean autograft annulus diameter exhibited an increase of 8.44% in the first month (1.44 +/- 0.22 cm/m2 vs. 1.55 +/- 0.21 cm/m2, p = 0.0101). An additional aortic annular dilation of 11.33% from baseline preoperative values was observed within the first year (1.41 +/- 0.15 cm/m2 preoperatively vs. 1.57 +/- 0.22 cm/m2, p = 0.0449). After the immediate postoperative period, the pulmonary autograft seemed to adapt to systemic circulation, and there were no differences in aortic annular size between 1-3 months after surgery and the 18-21 month follow-up period (1.60 +/- 0.18 cm/m2 vs. 1.60 +/- 0.27 cm/m2, n = 10). Diameter increase was not associated with the presence of aortic regurgitation. Mean neo-aortic maximal gradient was 7.85 +/- 5.59 mm Hg (3-29 mm Hg). There was a significant decrease in left ventricular size three months after surgery (50.71 +/- 10.20 mm preoperatively vs. 44.98 +/- 7.29 mm, p = 0.0491 in aortic stenosis patients and 68.50 +/- 8.39 mm vs. 59.04 +/- 9.21 mm, p = 0.0017 in aortic insufficiency patients). CONCLUSIONS: Pulmonary autograft annulus increases up to the first year after the Ross procedure but does not appear to progress beyond that time. The pulmonary autograft allows optimal hemodynamic performance without causing substantial aortic regurgitation, thereby permitting normalization of left ventricular dimensions and improvement of left ventricular function early in the postoperative period.

Adolescent↗
PubMed2000

Pathogenic significance of methicillin resistance for patients with Staphylococcus aureus bacteremia.

To assess whether methicillin resistance is a microbial characteristic associated with deleterious clinical outcome, we performed a cohort study on 908 consecutive episodes of Staphylococcus aureus bacteremia and a case-control study involving 163 pairs of patients matched for preexisting comorbidities, prognosis of the underlying disease, length of hospitalization, and age. Of 908 bacteremic episodes, 225 (24.8%) were due to methicillin-resistant S. aureus (MRSA). Multivariate analysis did not reveal that methicillin resistance was an independent predictor for mortality when shock, source of bacteremia, presence of an ultimately or rapidly fatal underlying disease, acquisition of the infection in an intensive care unit (ICU), inappropriate empirical therapy, female sex, and age were taken into account. Nonetheless, methicillin resistance was an independent predictor for shock. The case-control study could not confirm that shock was linked to MRSA when prior antimicrobial therapy, inappropriate treatment, ICU residence, and female sex were considered. Our data suggest that cohort studies tend to magnify the relationship of MRSA with clinical markers of microbial pathogenicity and that this effect is a shortcoming of these kind of studies that is caused by inadequate control for underlying diseases.

Adult↗
PubMed2000

Relationships between bilateral asymmetry and tonic immobility reaction or heterophil to lymphocyte ratio in five breeds of chickens.

Bilateral asymmetry of several morphological traits, tonic immobility reaction, and leucocyte ratio were studied in hens and cocks from four Spanish breeds of chickens (Castellana, Buff Prat, Red Villafranquina, and Barred Red Vasca) and an F2 cross between Castellana and Buff Prat (C x BP - F2). Any two or all three types of bilateral asymmetry (fluctuating asymmetry, directional asymmetry, and antisymmetry) occurred together for the same trait in the different breeds. There was a significant difference in relative asymmetry among breeds (P < 0.05) for feather and spur lengths in males, and considerable negative heterosis for relative asymmetry of leg and wing lengths in C x BP - F2 males (-38 and -12%, respectively). The degree of relative asymmetry varied among traits and was between 3 and 12 times greater for spur length in males and for wing bay area in Villafranquina males. There were significant differences among breeds (P < 0.05) for tonic immobility duration. The duration of tonic immobility was positively associated with the mean relative asymmetry of all traits in females from the Villafranquina breed (r = 0.32; P < 0.05), but this finding was not consistent across the different breeds. No significant difference was found among breeds in terms of heterophil to lymphocyte ratio. Although there was no significant association between mean relative asymmetry of all traits and heterophil to lymphocyte ratio, males from the Villafranquina breed had a positive and significant relationship between relative asymmetry for wing bay area and leucocyte ratio (r = 0.34; P < 0.05). These results suggest that relative asymmetry measures did not provide a general tool to assess fear or stress susceptibility.

Animals↗
PubMed2000

Long term outcome of infective endocarditis in patients who were not drug addicts: a 10 year study.

OBJECTIVE: To determine the clinical features and long term prognosis of infective endocarditis in patients who were not drug addicts. DESIGN: Prospective case series. SETTING: A university hospital that is both a referral and a primary care centre. PATIENTS: 138 consecutive cases of infective endocarditis diagnosed and treated from January 1987 to March 1997. RESULTS: Mean patient age was 44 (20) years old. 95 patients (69%) had native valve endocarditis and 43 (31%) had prosthetic valve endocarditis. Staphylococci were the causal microorganisms in 34% of cases and streptococci in 33%. Severe complications occurred in 83% of patients and 51% of patients underwent surgery during the active phase (22% was emergency surgery). Inpatient mortality was 21%. During a follow up of 56 (44) months, 10 patients (9%) needed late cardiac surgery and seven (5% of the whole series) died. Overall 10 year survival was 71%. There were no significant differences in survival depending on the type of treatment received during the hospital stay (medical or combined medical-surgical). CONCLUSIONS: A high early surgery rate is related to good long term results and does not increase in-hospital mortality. Medical treatment, however, also offers favourable long term results in cases of responsive infective endocarditis where poor prognostic factors are absent.

Adult↗
PubMed2000

[Aortic valve replacement with pulmonary autograft (the Ross procedure) in adult and pediatric patients].

Aortic valve replacement with pulmonary autograft was first performed by Donald Ross in 1967. Initially, the procedure was not widely accepted, by Cardiologists and Cardiac surgeons fundamentally due to its complexity and demanding surgical technique, and because innumerous series two cardiac valves were at risk. The results published in the last 10-15 years established the pulmonary autograft as one of the best methods of aortic valve replacement, especially in pediatric patients and young adults. In the present article, we reviewed present indications and contraindications, and our clinical experience with 26 patients (pediatrics and adults). Analysis of the first 22 the patients with a minimum of 6 months of follow-up (180-620 days) was performed. Follow-up is complete (100%). Mean age was 31.4 +/- 12.6 years. Five patients were pediatrics (<= 14 years). Three patients (11%) with previous percutaneous procedures and 4 patients (14%) with previous surgical procedures. There was no early or late mortality. In the last follow-up, 19 of 22 (86.36%) had no autograft insufficiency (>= grade 1), and in one patient it was moderate (grade 2). The 2 remaining patients developed severe autograft insufficiency (grade 4) and were reoperated on, with satisfactory postoperative outcome. Mean maximal gradient was 7.85 +/- 5 mmHg at 18 months (3-29). Patients with preoperative aortic stenosis showed a significant reduction in myocardial mass index (208.7 +/- 32 a 95.8 +/- 28.8 g/m2) at 18 months. In these patients, septal and posterior wall thickness decreased significantly, in the first month. Two pediatric patients have developed transpulmonar gradient > 50 mmHg. One of them underwent successful stent implantation. We have not observed significant homograft insufficiency in any of our patients. All our patients remain asymptomatic (functional class I) without medical treatment. We have not observed either thromboembolic or haemorrhagic episodes, nor endocarditis. No patient is receiving anticoagulants. Clinical and echocardiographic mid term results in pulmonary autograft and homograft in our series, are excellent after the Ross procedure.

Adult↗
PubMed1999

[Aortic valve replacement with a pulmonary autograft (the Ross operation) in adult and pediatric patients. A preliminary study].

INTRODUCTION AND OBJECTIVES: Aortic valve replacement with the patients own pulmonary autograft (the Ross procedure) is by now, the best surgical method for the replacement of the diseased aortic valve in certain groups of patients, this is particularly true for young adults and children or neonates with complex left ventricular outflow tract obstructions. The procedure was described by Donald Ross in 1967, and many years have passed. So in view of the accumulated experience the indications have extended to a wide group of patients which include children, neonates and young adults with formal contraindications for anticoagulation. In this publication we present our experience and our preliminary results in a group of fifteen patients which include adult and pediatric. MATERIAL AND METHODS: In six patients the etiology of lesion was congenital and in the remainder nine the valve had an acquired lesion. Two patients had an open heart procedure before this operation both of them to relieve an obstruction to the left ventricular outflow tract. In this group of patients the Ross procedure was carried out inserting the pulmonary autograft in the aortic position as a total root which was always reconstructed with cryopreserved pulmonary homograft, the mean homograft diameter was 26.1 +/- 4 mm (19-35). RESULTS: In all patients a transesophageal echocardiogram was performed in the operating room and postoperative, 1 or 2 months later. Only in one patient a mild aortic regurgitation was detected, no significant transaortic or transpulmonary gradients were detected postoperative. One patient was reoperated for bleeding in the postoperative course, there was no hospital mortality in our group and all the patients had an uneventful postoperative period. In the short term follow-up (41-155 days). All the patients are free of anticoagulant therapy, all them are in New York Heart Association Functional Class I. CONCLUSIONS: The patients presented in this publication which include adult and pediatric, are the first group of patients operated in our country with some excellent preliminary results. We hope that this procedure will become popular and that other surgical groups will adopt it as another surgical tool to replace a diseased aortic valve.

Adolescent↗
PubMed1998

Ultrasonographic appearance of an echinococcus ovarian cyst.

BACKGROUND: We describe the ultrasonographic pattern of a pelvic echinococcus cyst, visualized using a vaginal probe and color Doppler. CASE: A 27-year-old woman presented with an asymptomatic right adnexal mass. Vaginal ultrasonography revealed a cyst in the posterior cul-de-sac, adjacent to the right ovary, with internal septae resembling a maze or an onion slice structure. Color Doppler revealed peripheral vascularization with a low resistance pattern (resistance index 0.6; pulsatility index 0.93). Benign cysts usually have a simple echogenic pattern. In contrast, ovarian carcinomas have a complex internal structure. CONCLUSION: Ovarian echinococcus cysts may have a peculiar ultrasonographic pattern at high-frequency (7.5-MHz) vaginal ultrasonography. Such high-frequency ultrasonography can be a useful tool in the diagnosis of the disease.

Adult↗