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J A Castillo

Publications and source records attributed to J A Castillo.

At least 55 records · Page 3Linked to original sources
PubMed1995

[Cardiac tamponade with the absence of a paradoxical pulse. The practical utility of echocardiography].

A patient with cardiac tamponade but without hypotension and pulsus paradoxus is reported. In this patient, echocardiography confirmed the diagnosis of cardiac tamponade, showing diastolic collapse of the right ventricle and also the presence of an atrial septal defect (ostium secundum) that explains the absence of pulsus paradoxus. The role of echocardiography in those rare clinical situations that in the presence of cardiac tamponade showed no pulsus paradoxus are discussed.

Cardiac Tamponade↗
PubMed1994

Usefulness of transesophageal echocardiography for diagnosis of infected transvenous permanent pacemakers.

BACKGROUND: Transesophageal echocardiography is superior to transthoracic echocardiography in detecting left-sided valvular vegetations. There are no data on the value of transesophageal echocardiography in the diagnosis of infected transvenous permanent pacemakers. METHODS AND RESULTS: Transthoracic and transesophageal echocardiography was performed in 10 patients for whom there was clinical suspicion of infected permanent transvenous pacemakers. Transthoracic echocardiography detected pacemaker lead vegetations in 2 patients, whereas transesophageal echocardiography visualized pacemaker lead vegetations in 7 patients. Surgical confirmation was obtained in 6 of these 7 patients. Most patients had more than one pacemaker electrode in place. Local complications at the generator pocket were present in 6 patients. Staphylococcus was the predominant causative organism. CONCLUSIONS: Transesophageal echocardiography is superior to transthoracic echocardiography in the detection of pacemaker lead vegetations.

Aged↗
PubMed1994

Factors affecting Dirofilaria immitis prevalence in red foxes in northeastern Spain.

We determined the prevalence of Dirofilaria immitis (Nematoda, Filariidae) among 433 red foxes (Vulpes vulpes) in northeastern Spain, between 1990 and 1992. Forty-six (11%) of 433 foxes were infected; the intensity ranged from 1 to 36 (mean +/- SE; 4.39 +/- 0.92) nematodes per host. The prevalence of D. immitis was higher in foxes inhabiting riparian zones of the study area. This population has a very high juvenile/adult ratio. Heartworm prevalences did not differ among host sex, weight, or fat condition categories.

Age Factors↗
PubMed1994

[The evaluation of the mechanism of mitral bioprosthesis malfunction by transesophageal echocardiography].

OBJECTIVES: The aim of this study was to assess the usefulness of transesophageal echocardiography for detection of the mechanism of dysfunction in bioprosthetic valves in the mitral position. METHODS: Transthoracic and transesophageal echocardiograms were performed in 40 patients (mean age 61 +/- 12 years) with a dysfunctional bioprosthetic mitral valve. Echocardiographic results were compared to surgical findings in all except 1 patient. RESULTS: All 9 patients with stenotic degenerated bioprosthesis were diagnosed by transthoracic and transesophageal echocardiography. Mechanism of dysfunction in the remaining patients were as follows: cusp tear or rupture in 18, dehiscence in 4 and endocarditis in 6. Transthoracic and transesophageal echocardiography visualized respectively: 8 (44%) and 15 (83%; p < 0.05) with cusp tears or ruptures; 3 (75%) and 3 (75%) with dehiscence; 3 (50%) and 6 (100%; p < 0.1) with endocarditis. One patient with pannus formation and 1 of 2 bioprosthetic thrombosis were not correctly identified by either echocardiographic technique. CONCLUSIONS: Transesophageal echocardiography is suited for the assessment of mechanism of mitral regurgitation and for the diagnosis of vegetations in most of patients with bioprosthetic mitral valves. Transesophageal echocardiography adds little information to the transthoracic study in the evaluation of patients with stenotic bioprosthetic mitral valves, particularly in calcified degeneration.

Adult↗
PubMed1994

[Contribution of transesophageal echocardiography in the assessment of cardiac myxomas].

INTRODUCTION AND OBJECTIVES: Transthoracic echocardiography is the gold-standard method in the diagnosis of cardiac myxomas. Our aim was to analyze the usefulness of transesophageal echocardiography in the diagnosis and assessment of patients with cardiac myxomas. PATIENTS AND METHODS: From 1990 to 1992, 14 patients underwent cardiac surgery with the echocardiographic diagnosis (transthoracic and/or transesophageal approach) of cardiac myxomas. Thirteen (86%) of the 14 patients had after surgery histological confirmation of myxoma. Of the 13 myxomas, 10 were located in the left atrium and 3 in the right atrium. RESULTS: Transthoracic echocardiography was able to diagnose the presence of myxoma in 12 of the 13 patients, whereas the transesophageal approach detected all of them. The precise attaching point of the tumour was seen in 9 patients with transthoracic echocardiography and in all the patients with the transesophageal approach. Also the presence of satellite tumours seen in 2 patients was only detected by transesophageal echocardiography. CONCLUSION: We conclude that the sensitivity in the diagnosis of cardiac myxomas is similar with both techniques, but transesophageal echocardiography is much more accurate in the detection of the precise attaching point and the presence of satellite tumours. We think that TEE is a useful tool, complementary to TTE, in the assessment of patients with cardiac myxomas before going to surgery.

Echocardiography, Transesophageal↗
PubMed1994

[A comparison of echocardiography with dobutamine administration and the stress test in detecting coronary disease].

INTRODUCTION: Echocardiography with dobutamine has been proposed as a useful tool in the diagnosis and assessment of coronary artery disease. PATIENTS AND METHODS: To determine the usefulness of echocardiography combined with dobutamine infusion (10 micrograms/kg/min, with increments of 10 micrograms/kg/min every 3 min up to 40 micrograms/kg/min) and atropine if submaximal heart rate is not achieved in detecting coronary artery disease, 45 patients with chest pain underwent this test, exercise stress test and coronary angiography. RESULTS: No significant differences were found between double product (peak heart rate x systolic pressure) after dobutamine infusion (18,774) and after exercise (16,950; p = NS). Significant coronary artery disease, defined as having 70% stenosis in, at least, one major vessel, was present in 30 patients. Although overall sensitivity of dobutamine echocardiography test (70%) was similar than that obtained by exercise stress test (66%), sensitivity of the subgroup of patients with single-vessel disease was significantly higher (66 vs 42%, respectively; p < 0.05). Specificity was slightly higher with dobutamine echocardiography test (94%) than with exercise stress test (66%; p = 0.07). Side effects and major complications (hypotension, ventricular tachycardia, heart failure) were present in 8 (18%) and 3 (6%) patients, respectively. ECG during dobutamine administration become positive for ischemia in 17 patients with and 1 without coronary artery disease. CONCLUSIONS: Dobutamine echocardiography test is highly sensitive and specific for the detection of coronary artery disease. Its sensitivity in patients with single-vessel disease is better than that obtained by exercise stress test. Complications after dobutamine infusion must be kept in mind.

Aged↗
PubMed1993

[Transthoracic and transesophageal echocardiography in the pre- and postoperative assessment of interatrial communication].

BACKGROUND AND OBJECTIVES: Transthoracic echocardiography is the most useful noninvasive method to diagnose atrial septal defect. It is suggested by some authors that transesophageal echocardiography is more accurate than transthoracic echocardiography in this setting. Our aim was to compare the usefulness of both techniques in: 1) diagnosing atrial septal defect, 2) detecting associated anomalies and 3) postoperative assessment. PATIENTS AND METHODS: Pre and postoperative transthoracic and transesophageal echocardiography were performed in 27 patients in whom diagnosis of atrial septal defect was confirmed at surgery. RESULTS: Transthoracic echocardiography demonstrated the defect in 20 patients (74%) (8 ostium primum, 10 ostium secundum and 2 sinus venosus). The 27 patients (100%) were correctly diagnosed by transesophageal echocardiography (8 ostium primum, 12 ostium secundum and 7 sinus venosus). Defect size determined by transthoracic echocardiography had a poor correlation with the surgical measurement (r = 0.34). A good correlation was obtained when transesophageal versus surgical defect size measurements were compared (r = 0.85; p < 0.05). Transesophageal echocardiography was superior in detecting associated anomalies (5 patients with anomalous partial pulmonary venous drainage, 3 persistence of left superior vena cava and 1 atrial septal aneurysm). Moreover, this technique better determined residual atrial septal defect, and detected a postsurgical inferior vena cava connection to the left atrium. CONCLUSIONS: Transesophageal echocardiography is superior to transthoracic echocardiography in diagnosing atrial septal defect sinus venosus type, detecting associated anomalies and postoperative assessment. Transthoracic echocardiography is diagnostic in the majority of patients with atrial septal defect ostium primum and ostium secundum types.

Adolescent↗
PubMed1993

Immune complex-mediated glomerulopathy in Barbus graellsi infected with Myxobolus spp.

Membranous glomerulonephritis caused in Barbus graellsi by myxosporidian infections have been studied by electron microscopy and immunoelectron microscopy techniques. This study indicates that Myxosporidian infection produces a chronic severe aggression. Spores reach the spleen, the kidney and the liver, where they are trapped and phagocyted by Melano Macrophage Centres. Consequently, the commencement of a immunological response to myxosporidian is evident. Our results show the presence of immunodeposits in the basement membrane of the glomeruli, suggesting that they might initiate glomerulonephritis. The lesion was markedly similar to immune complex-mediated glomerulonephritis disease in higher vertebrates.

Animals↗
PubMed1993

[Papillary muscle rupture. Diagnosis with transesophageal echocardiography].

Two patients with acute myocardial infarction and papillary muscle rupture are presented. The diagnosis of papillary muscle rupture was made by transesophageal echocardiography. The transesophageal echocardiographic findings and the usefulness of this technique in the diagnosis of papillary muscle rupture are described.

Adult↗
PubMed1992

[Elective coronary angioplasty in recurrent ischemia after successful fibrinolysis in myocardial infarction. Comparison with results of angioplasty in the acute phase].

To assess the initial and long-term results of 149 percutaneous transluminal coronary angioplasty (PTCA) procedures performed within 1 month of an acute myocardial infarction (AMI), 83 of them because of recurrent ischemia (post-infarction angina) after thrombolytic therapy with initial reperfusion success in the AMI (100 lesions attempted) (group I) and 66 PTCAs (69 lesions) performed during the acute phase of the AMI (group II). Mean age was 56 +/- 14 and 127 (85%) patients were male. Although successful dilation was obtained in 151 (89%) of the 169 attempted lesions, (96[96%] in group I vs 55[78%] in group II), clinical success was obtained in only 123 (82%) (76[92%] vs 64[77%] in both groups, respectively). Late occlusion occurred in 14 (9%) of the 151 lesions successfully dilated (6[6%] and 8[15%], respectively) and reinfarction was documented in 7 (5%) patients (5[5%] and 2[3%]). One patient in group I underwent coronary bypass surgery. There were 4 (3%) hospital deaths (1[1%] and 3[4%]) in group I and II, respectively). Event-free (no occurrence of death, AMI, coronary surgery, repeat PTCA or angina recurrence) survival rate was 76%, 73% and 67% in group I versus 62%, 57% and 40% in group II, at 1, 2 and 4 years respectively. During follow-up, 1 (1%) patient of the group I and 4 of the group II died. At last follow-up, 63 (78%) of the 81 patients alive vs 33 (67%) of the 59 patients in the group I and II respectively remained asymptomatic. In conclusion, in our experience elective PTCA performed in the subacute phase after an AMI provides better initial and long-term outcome than that performed in the acute phase. Therefore, the procedure would be delayed whenever possible.

Adult↗