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J A Martín

Publications and source records attributed to J A Martín.

At least 19 recordsLinked to original sources
PubMed2006

[Sigmoid colon vaginoplasty: experience with five cases].

Vaginal atresia compounds a rare congenital anomaly and results from anomalies in the development of Müller ducts as happens in the Mayer-Rokitansky syndrome or in other cases of intersexual states. Some different tissues have been issued for the creation of a neovagina, but none of them has been accepted as ideal. We have chosen sigmoid colon in order to create a new vagina functionally appropriate. We present five cases affected of vaginal atresia. Two of them were Mayer-Rokitansky syndromes and the other were diagnosed during the study for primary amenorrhea as a result of an intersexual state. In all cases a vaginoplasty was performed according to Baldwin's technique in the ages between 15 and 20 year-old. The follow up has been from 1 to 16 years. No postoperative complications have been observed. The external aspect of the genitalia is normal and a proper sized with length and lubrificated vagina was attained in all cases without any retraction in any patient. Two of the patients maintain sexual relations without problems. In our experience, the cosmetic and functional result of sigmoid vaginoplasty were excellent.

Adolescent↗
PubMed2005

Fourier transform-infrared spectroscopy as a new method for evaluating host resistance in the Dutch elm disease complex.

Resistance of elms (Ulmus spp.) to the pathogenic fungus Ophiostoma novo-ulmi Brasier depends on chemical and anatomical factors that confine the spread of the pathogen in the vascular system of the host. This study focused on detecting chemical differences in 4-year-old Ulmus minor Mill. seedlings before and after inoculation with a virulent O. novo-ulmi isolate. According to symptom development over 60 days, the trees were divided into resistant (0-33% wilting) and susceptible (67-100% wilting) groups. Histochemical tests and Fourier transform-infrared (FT-IR) spectroscopy analysis were performed on transverse sections of 2-year-old twigs, 2 days before and 40 days after inoculation. Although histochemical tests did not clearly discriminate susceptible from resistant elms, chemical differences between resistant, susceptible and control trees were detected by FT-IR. The average spectrum for resistant tree samples had higher absorbance peaks than the spectra from the susceptible and control samples, indicating increased formation of lignin and suberin. The roles of lignin and suberin in the resistance of the elms against O. novo-ulmi and the usefulness and sensitivity of the FT-IR technique for analyzing metabolic changes caused by pathogens in plants are discussed.

Ascomycota↗
PubMed2005

Seasonal changes in wood formation of Ulmus pumila and U. minor and its relation with Dutch elm disease.

Elms containing narrow and scattered vessels have been reported to be more resistant to Ophiostoma novo-ulmi (Dutch elm disease pathogen) than elms with large and contiguous vessels. However, recent measurements in Ulmus pumila and U. minor showed a contrary trend. The pin method was applied to 4-yr-old branches of eight clones planted in Madrid. During 2002, radial growth increments and vessel diameters were measured monthly, and beetle trapping was undertaken weekly. U. minor formed larger vessels at the beginning of the season, coinciding with a peak of captured beetles, but, up to June 15, vessels were larger for U. pumila. The number of vessels per group, the transversal area per vessel group, and the mean theoretical hydraulic conductances were significantly higher for U. minor on most dates. Researchers should take into consideration the seasonal changes in vessel size. The results highlight that seasonal variation of vessel diameters and hydraulic parameters, in combination with beetle abundance, are the main factors that could explain the different susceptibility of both elm species to O. novo-ulmi.

Animals↗
PubMed2004

[Good results with Passerini's technique in severely masculinised female pseudohermaphroditism].

In female pseudohermaphroditism due to congenital adrenal hyperplasia (CAH), some cases develope a very important masculinization degree with a high outlet of the vagina above the outern urethral sphincter. There are several surgical techniques to solve this problem. Our group uses Passerini's thecnique since 1990. 9 Girls with CAH with extreme masculitation (IV and V Prader degree) have been operated with this technique. The age at intervention varies between 9 months and 3 years, with a follow-up between 1 and 12 years. All these patients had hormonal studies, demostrating a deficiency of 21-hydroxilase in 8 cases and a deficiency of 11-B-hydroxilase in one case. To determine the vaginal outlet a genitography was performed in all cases, vaginoscopy in 7 cases and MNR in 2 cases. Passerini's technique consists of two phases: the first step has the objective of forming the distal 2/3 of the vagina using the skin and the urethral mucosa of the phallus. At the second time transtrigonal way is performed to access the vagina which is desinserted from its urethral outlet and anastomosed with the distal neovagina. There were no significative complications in immediate time. The esthetic result is acceptable in all cases, although one case had to be surgically repaired because of a prominent vulvar flap. We use vaginoscopy to prove vaginal permeability in all cases although one of them developed adherences around the anastomosis. This severe genital malformation, very uncommon, has a difficult surgical solution. Passerini's technique allows, with less complications, to create an acceptable outer genitals at early age and only in one surgical time.

Adrenal Hyperplasia, Congenital↗
PubMed2002

[HIV prevalence among homosexual and bisexual men in Spain, 1992-2000].

BACKGROUND: Our purpose was to describe the time trend in HIV seroprevalence among homo/ bisexual men. SUBJECTS AND METHOD: We analyzed 9,383 homo/ bisexual men who had a first voluntary test for HIV in 10 Spanish clinics from 1992 to 2000. RESULTS: HIV prevalence decreased from 20.3% in 1992 to 8.4% in 2000. In the multivariate analysis this decline appeared independently associated with the testing year and the birth cohort. CONCLUSIONS: New generations of voluntarily tested homo/bisexual men are less infected by HIV, but it is yet necessary to intensify the prevention programs.

Adolescent↗
PubMed2001

Effect of cadmium acetate on the conformation of lysozyme: functional implications.

Structural variations of lysozyme as a consequence of its interaction with CdAc2, as well as the implications on the protein functionality have been studied. Variations in the conformation of the macromolecule are seen, however these changes are not reflected on the secondary structure. The interaction of the salt with the polypeptide chain is weak and thermodynamically unfavourable. Molecular aggregates (dimer forms) are observed at the highest salt concentrations. This interaction causes an inhibitory effect on lysozyme, the activity loss being 50% at the highest salt concentration studied. The inhibition is of mixed type with an uncompetitive component. Thus cadmium does not bind to the active site of the enzyme which is in accordance with the not very large activity loss observed. The substrate inhibition of lysozyme is favoured in the presence of the salt, so interaction with the macromolecule is at low affinity sites.

Acetates↗
PubMed1998

[Ten years of prenatal diagnosis of uropathies. Study and conclusions].

Since uropathy started to be diagnosed by means of ultrasonography during the prenatal period, paediatric urologists have experienced a major increase in neonatal consultations, which involve healthy children without any symptoms of urinary tract infection. Thereby the criteria for an adequate treatment of these uropathies have been modified. With our study, we intend to analyse the changes regarding the management of such cases in our Service for the last 10 years. 294 cases prenatally diagnosed and confirmed by means of postnatal sonography have been reviewed, taking into account the type of explorations carried out in order to obtain a definitive diagnosis. Ultrasonography, cystourethrography, pyelography, scintigraphy and isotopic renography have determined both degree of obstruction and the renal function of the patient so as to value the kidney viability. We have found 169 cases of pelviureteral junction (PUJ) obstruction, 52 of vesicoureteral reflux (VUR), 48 of megaureter, 13 of ureterocele, 8 of ectopic ureter, 5 of urethral valves, 26 of multicystic dysplasic kidney, 35 of renal duplication, 4 of renal cyst, 2 of ectopic kidney, 2 of renal agenesia, 3 of bladder diverticular, 1 of renal hypoplasia and 1 of Bolande's tumour. 32 children were operated upon due to PUJ obstruction, 27 due to VUR, 14 megaureter, 21 due to ureterocele and ectopic ureter, 5 due to valves, 5 multicystic kidneys, 3 vesical diverticula, 2 renal cysts and 1 due to Bolande's tumour. From a total of 367 diagnoses, 109 patients have undergone an operation, which equals a 29.7%. The rest of the patients have been subject to a medical follow-up. Only 3 patients had to be operated on due to an aggravation of their obstruction. To sum up, the main advantage of prenatal diagnosis is that it presents the patient without urinary infection. Double-diuretic scintigraphy has proved to be the best option to explore the obstruction when dilated despite its limitations in the case of deficient renal function. The most frequent diagnosis, which has undergone a major increase in the last few years, is PUJ obstruction in the manner of pyelic dilatation. Many of them are not confirmed postnatally and most of them (more than 70%) do not need surgical treatment.

Female↗
PubMed1998

[Anterior urethral valves].

The valves of the anterior urethra are a rare congenital malformation, but it can cause a significant deterioration of the uppermost urinary system due to their obstructive patterns. It's placed fundamentally in the peno-scrotal union or in the bulbous urethra. They can associate to the diverticula of the anterior urethra. The clinical manifestations can be varied, depending upon the age of the child and the degree of obstruction that provoque. The treatment is always surgical, although in some occasions they suffice the endoscopic resection. We present the 12 cases controlled in our Center, with known ages between 1 month and 7 years, that began with tumefaction urethral at micturition in 7 cases, urinary infection in 6 and sepsis in 2. All of them required open surgery, after the failure of endoscopic resection in one of them. The results have been favorable in 9 cases regarding to the repercussions in the renal function. Two patients had a need of nephrectomy and one had to be subjected to a renal transplantation. The jet at micturition after surgery is good in 10 cases. In one, there persists a subtle jet, although without clinical repercussions, and in one patient there appeared a slight dilation in the posterior urethra.

Child↗
PubMed1998

[Autologous buccal mucosal graft for urethral reconstruction].

Proximal hypospadias are a difficult surgical problem, whether it could take place different surgical approaches. One of those is based on the creation of a neourethra using a free buccal mucosal graft, as a patch or a tube, obtained from de lips or cheek. Since 1983 we have been using this technique in 8 patients. The urethral meatus was penoscrotal in 3, scrotal in 3 and perineal in 2. There was a significant chordee in 3 patients. Hormonal treatment was necessary in 5 patients. The average age for surgery was 3.5 years. The graft was tubularized in all the cases. The free buccal mucosal graft was combined with a distal Duckett procedure in 6 patients. Two patients received only a free buccal mucosal graft. The final result is satisfactory in all the cases, with a good urinary jet. The complications were 7 urethrocutaneous fistulas, 5 of whom needed a surgical repair, and 2 stenosis, which also needed surgical repair.

Child, Preschool↗
PubMed1997

[Evaluation of hospital emergency service attendance by patients from a basic health district].

OBJECTIVES: To find the sociodemographic characteristics of patients registered at a Health Centre (HC) who attended a hospital Casualty Department, their reasons for attendance, features of their use of facilities and how justified their attendance was. DESIGN: Descriptive study. SETTING: Urban Health Centre, Llefià (Badalona), between February and June, 1995. PARTICIPANTS: We used a questionnaire composed by the research team to survey 360 patients over 14 who attended the HC with a report from a Casualty Department. MEASUREMENTS AND RESULTS: The variables recorded were: sociodemographic characteristics, reasons for attending Casualty, whether they attended on their own initiative, whether they knew about non-hospital Emergencies, the hospital, day and time, chronic pathology, diagnosis and destination on discharge from Casualty, length of stay and justification. 53.7% were women. 57.8% were married. 95% lived with a partner or intimate family member, 56.9% had completed primary education and 39.4% had jobs. 41% suffered a chronic pathology. Monday was the busiest day and physical trauma was the most frequent diagnosis on discharge. We considered 54.7% of all the consultations non-justified emergencies. CONCLUSIONS: There is a high percentage of users who attend Casualty on their own initiative. Most of the emergencies are unjustified.

Adolescent↗
PubMed1997

[Preoperative coronary angiography in valve patients. Criteria for indication in a determined population].

BACKGROUND AND PURPOSE: The indication for preoperative coronary angiography in patients with valvular heart disease depends on the prevalence of coronary disease in these patients, which differs among different geographical areas. Our aim was to determine the indication criteria for preoperative coronary angiography in our population. METHODS: We studied retrospectively the prevalence of significant coronary disease in 511 consecutive patients with valvular disease diagnosed by non-invasive methods, who underwent preoperative coronary angiography from August/1991 to July/1996. We analyzed in each patient: demographic data, symptoms and presence of risk factors for coronary artery disease. We considered that preoperative coronary angiography had to be performed on patients who had a coronary artery disease prevalence > or = 5%. RESULTS: Mean age was 64 +/- 10 years (51% male). There was mitral valvulopathy in 135 patients, aortic in 234 and combined mitro-aortic in 142. Angina was present in 30% of patients, and risk factors for coronary artery disease in 52%. The prevalence of significant coronary disease was 20.3%. It was significantly higher in patients with angina (35.3% versus 13.8% in patients without angina) and in those with risk factors (28% versus 12.2% in patients without risk factors); no differences between valvulopathies were found. Age was significantly higher in patients with coronary disease (69 +/- 8 versus 63 +/- 10 years). Multivariate analysis showed three independent predictors for significant coronary disease: 1) age; 2) previous angina, and 3) risk factors. Regarding the prevalence of significant coronary disease in patients neither angina nor risk factors was < 5% in males who were under 60 years old (1 man; 3.3%) and in females under 65 years old (2 women; 3.5%). CONCLUSIONS: In our reference population and in others with a similar cardiovascular profile, preoperative coronary angiography is indicated in males who are > or = 60 years old and in females who are > or = 65 years old, and in younger patients who present angina or risk factors, regardless of the valvulopathy present.

Adult↗
PubMed1996

[Isolated lesion of the Edinger-Westphal nucleus in topographical relation with a post-traumatic mesencephalic hematoma].

INTRODUCTION: From the relevant literature, it would seem that the commonest single cause of lesion of the third cranial nerves is indirect, accompanying intracranial traumas. From multiple clinical observations however, it seems that many of these cases may be due to lesions of the mesencephalum which nevertheless have rarely been identified by current imaging techniques. Clinical case. We describe the clinical observation of isolated pupil involvement, attributed to a lesion of the Edinger-Westphal nucleus as a consequence of a mesencephalic haematoma in the context of closed craneo-encephalic trauma. In our review of the literature, we have not found any other such case. CONCLUSIONS: We briefly review the most frequently involved mechanisms implicated in the genesis of lesions of the third cranial nerves at different sites and the different changes seen in the pupil in each case, together with the characteristics and pathogenesis of the lesions produced in the mesencephalum as a consequence of intracranial trauma. We emphasize the importance of our case as being the first time an isolated lesion of the Edinger-Westphal nucleus has been described in topographic relation to a mesencephalic haematoma.

Hematoma↗
PubMed1996

[Influence of the degree of aortic valve calcification on the estimate of valvular area using planimetry with transesophageal echocardiography].

BACKGROUND AND PURPOSE: Continuity equation to measure aortic valve area is limited by poor acoustic window or difficulty in obtaining acceptable Doppler signal. Our aim has been to analyze the accuracy of planimetry by transesophageal echocardiography to calculate aortic valve area and the impact of calcification on results. METHODS: Planimetry of aortic valve area by transesophageal echocardiography has been compared to continuity equation by transthoracic approach and the Gorlin formula in 26 consecutive patients with aortic stenosis. Degree of calcification was qualitatively estimated by the 3 methods and 2 groups were distinguished: group A (mild or moderate calcification) and group B (severe calcification). RESULTS: An excellent agreement between continuity equation and the Gorlin formula was found (mean difference: 0.03 +/- 0.15 cm2). Agreement between transesophageal planimetry and the Gorlin formula was poor (mean difference: 0.14 +/- 0.25 cm2). Planimetry and the Gorlin formula demonstrated an excellent agreement in group A (mean difference: -0.03 +/- 0.17 cm2). By contrast, agreement in group B was not acceptable (mean difference: 0.27 +/- 0.22 cm2). CONCLUSIONS: 1) continuity equation by transthoracic echocardiography is useful in calculating aortic valve area. 2) aortic planimetry by transesophageal echocardiography is an excellent method in noncalcified aortic valves, and must not be used on severely calcified valves.

Adult↗
PubMed1995

Subarachnoid-pleural fistula as a complication of the lateral-extracavitary approach to thoracic intraspinal neurinoma.

STUDY DESIGN: This report describes an infrequent but major complication resulting from a lateral extracavitary approach to the spinal cord. The diagnosis was made via myelography-computed tomography. OBJECTIVES: The authors emphasize the importance of a proper approach in diagnosing a subarachnoid-pleural fistula and treating this clinical condition correctly. SUMMARY OF BACKGROUND DATA: Myelography-computed tomography was used to diagnose the subarachnoid-pleural fistula. It was necessary to re-open the thoracotomy to seal the dura mater because the pleuroperitoneal shunting was not effective. METHODS: The patient presented with an intradural and extramedullary thoracic neurinoma located on the anterior part of the spinal canal that was causing anterior spinal cord compression. A lateral extracavitary approach was taken with a thoracotomy, with the tumor being completely removed. During the postoperative period, the patient had a persistent pleural effusion. The diagnosis of a cerebrospinal fluid fistula was made via myelography-computed tomography. Implantation of a pleuroperitoneal shunt was unsuccessful, and it was necessary to re-open the thoracotomy to seal the dura mater. RESULTS: Myelography-computed tomography successfully helped diagnose the subarachnoid-pleural fistula and identify the precise anatomic location of the leakage. Pleuroperitoneal shunting was not effective in dealing with the pleural effusion. CONCLUSIONS: This complication should be taken into account when this kind of surgical approach is performed. Myelography-computed tomography is the most reliable test for diagnosing this clinical condition and pinpointing the exact location of the leakage.

Female↗
PubMed1995

[Management of primary congenital megaureter with early diagnosis].

We present our follow-up protocol of congenital megaureter (PCM) diagnosed early thanks to showing prenatal ultrasound the dilatation in the urinary system. 47 PCM were studied retrospectively in 35 babies, out of 240 cases of prenatal renal dilatation, from 1984 to 1993. The final diagnosis was established with the early use of ultrasound, cystography, intravenous urography (IVU) and isotope test. The latter two gave hints as to the existence of obstruction, which was the main criterion for early surgery to be prescribed. The surgical treatment, when it was necessary, consisted of ureter reimplantation (Cohen type), following the resection of the stenotic segment. When it was necessary short distal tapering (3-4 cm) was performed. For the follow-up ultrasound, IVU and isotope test were used. Out of the 35 patients observed, 11 were girls and 24 boys, 9 (25.7%) of the PCM were from the right side, 14 (40%) from the left side and 12 (34.2%) bilateral. 36 PCM (76.6%) were non-obstructive and only follow-up was performed. 5 of them, in 3 patients, had infections and were operated on together with the 11 obstructed PCM. In total, 16 PCM were reimplanted, and associated tapering was need in 7 of them. Other 3 patients were operated on for associated pathology. The post-surgical complications were 2 cases or reflux and 1 uric stone that did not need surgery. The development of all cases was favorable. The protocol has been useful for the selection for early surgical intervention of the subsidiary megaureters from those that can be develop without risk.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMed1994

Asthma and contact urticaria caused by rice in a housewife.

We report the case of an atopic housewife who presented with rhinoconjunctivitis-asthma and contact urticaria from handling rice and other cereals. She tolerated cooke cereals. Both skin prick tests with a rice extract (20% w/v) and a rub test with raw rice gave positive results. Bronchial challenge test with methacholine revealed a PC20 of 0.45 mg/ml. The challenge test with raw rice resulted in immediate and late clinical and spirometric responses; pretreatment with DSCG inhibited both responses. The histamine release test (HRT) with rice was positive, and we detected rice-specific IgE antibodies by REIA in the patient's serum. Skin prick tests, HRT, and RAST with a battery of cereals gave positive results. Finally, the rice REIA was inhibited by rice (75%), rye (63%), corn (64%), and wheat (51%) extracts.

Adult↗
PubMed1994

[Passerini-Glazel technique of vulvovaginoplasty: a solution for upper outlet of the vagina].

Since 1988, we have performed the Passerini-Glazel technique, in 5 patients, between 7 months and 3 years old. All showed female pseudohermaphroditism with severe signs of masculinization, and consequently, high outlet of the vagina in the urethra, secondary to Congenital Adrenal Hyperplasia (CAH). The technique use is to get a functional and esthetically acceptable vagina at the expense of a urethral flap and two flaps of skin, coming from the hypertrophic clitoris. The results were excellent in all the patients. In one occasion it was necessary to insert a cylinder of vesical mucous to get a suture without tension of both hemivaginas. In one case there appeared a late vaginal stenosis that was solved with dilations. The present technique is indicated in those cases of CAH, with great testosterone impregnation, in which the vagina ends very high and her primary descent is difficult. It is also indicate in those cases in which there exists the risk of hurting the external sphincter, which would damage the urinary continence mechanism.

Child, Preschool↗