Biomedical subjects
J Catalá
Publications and source records attributed to J Catalá.
Cellulose granulomatosis of the lungs.
Chest radiographs and high-resolution chest CT scans were performed in a 30-year-old man with a history of intravenous drug abuse and diffuse micronodular infiltrates. Transbronchial biopsy gave a diagnosis of cellulose granulomatosis of the lung. Cellulose granulomatosis should be considered in the differential diagnosis of pulmonary interstitial disease, especially in the setting of intravenous drug abuse.
[A patient with pancytopenia and a liver mass].
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[Girl with pain and tumefaction in the proximal third of the leg].
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[Analysis of the situation of Valencian neurology by the Commission of Analysis of the Quality of Valencian Neurological Society].
INTRODUCTION: The Comision de Analisis de la Calidad de la Sociedad Valenciana de Neurologia has made a proposal of Neurology care requirements, based on the findings of various studies done in this region. There studies suggest that there should be a proportion of 3 neurologists per 100,000 inhabitants. METHOD: An analysis of requirements was made, based on evaluation of the public health service, private practice and trainee specialists (MIR) regarding this problem. The need for emergency neurological attention, and the place of a hierarchy and a system for referral was also considered. RESULTS: It was calculated that 109 neurologists are required, 11 in Castellon, 63 in Valencia and 35 in Alicante. This would mean a proportion of 2,66 neurologists per 100,000 inhabitants in Castellon, 2,90 in Valencia and 2,70 in Alicante. The total figure for the whole Community would be 2,82 per 100,000 inhabitants. CONCLUSIONS: At the present time neurological care is expensive, since a lack of specialists means waiting lists, poor patient care and high costs due to inappropriate use of technical resources.
[Chronic adhesive arachnoiditis following epidural paramethasone].
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[Scleromyxedema associated with myopathy].
We describe a 45 year-old man, with scleromyxedema associated to systemic manifestations, including myopathy. After 6 years of dermatologic manifestations, muscular weakness, with proximal predominance resulting in incapacity, was established. Corticosteroids plus cyclophosphamide treatment suppressed muscular symptomatology, and a second biopsy was normal. The common association between scleromyxedema and myopathy and other systemic alterations suggest that this entity should probably be considered as a systemic disease instead as a skin disease.
[Mortality from Parkinson's disease in Spain (1980-1985). Distribution by age, sex and geographic areas].
An approximation of Parkinson's disease in Spain was carried out based on the data of mortality by this disease over the period 1980-1985. The annual number of deaths by Parkinson's disease as well as its distribution by sex, age groups and Spanish provinces was obtained from information published annually by the National Institute of Statistics in the Natural Movement of the Spanish Population. The global mortality rate during the period studied was of 2.14 per 100,000 inhabitants. The specific mortality rate by Parkinson's disease in males was slightly higher than that of females. A specific mortality rate was also observed by age groups being higher in the older age groups. From the point of geographical distribution, higher rates were observed in the northern provinces with respect to the south and in rural areas compared to provinces capitals. Following the analysis of the results obtained and upon comparing the findings published in other countries it was concluded that place of residence may be related to the development of Parkinson's disease. From these data new epidemiological studies are required oriented to the identification of the environmental factors which may play a role in the etiology of this entity.
Thalamic demyelination and paroxysmal dystonia in multiple sclerosis.
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[Impetigo herpetiformis as initial manifestation of primary hypoparathyroidism].
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[Findings of computed tomography in the acute form of Marchiafava-Bignami disease].
We report a case of Marchiafava-Bignami's disease with acute evolution. Pathological examination was carried out and a cavitary lesion with discontinuous longitudinal extension was found throughout the corpus callosum. CT had shown a narrow hypodense area symmetrically localized just anterior to the frontal horns of the lateral ventricles, corresponding to the genus of the corpus callosum. The literature is reviewed, the anatomical-radiological correlations are discussed, and the possibility of the diagnosis of this condition during life is commented.
[Captopril-induced agranulocytosis].
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Long-term treatment with captopril in pediatric patients with severe hypertension and chronic renal failure.
Captopril was given to 42 hypertensive patients aged 1 to 17 years who were treated by regular haemodialysis because of terminal renal failure. Initially all patients were on antihypertensive treatment without sufficient control of blood pressure. Under captopril all patients presented a significant decrease of both systolic and diastolic blood pressures. The mean decrease of systolic blood pressure was from 162 to 114 and that of diastolic blood pressure from 106 to 86 mmHg. Plasma renin activity rose significantly in all cases whereas plasma aldosterone dropped and reached normal levels for age. The maximum effective dosage was 3 mg/kg/day. Total duration of treatment with captopril ranged from 1 1/2 to 6 1/12 (mean 3 2/12) years. At last observation the dosage of captopril varied between 0.3 and 3 mg/kg/day.
[Spontaneous dissection of the internal carotid artery. A report of two cases].
INTRODUCTION: Dissection of the internal carotid artery is a condition with a broad clinical spectrum. In absence of the classical triad of cervical pain, oculosympathetic ipsilateral paralysis and ischemic cerebral symptoms a considerable index of clinical suspicion is necessary to make a diagnosis. It is therefore considered to be probably underdiagnosed. The development of new techniques for neurovascular investigation, particularly ultrasound and magnetic angioresonance have improved the possibilities of diagnosis. CLINICAL CASES: In this paper we describe two cases of dissection of the internal carotid artery representing different clinical findings in the same condition. One patient presented with unilateral paralysis of the XI, X and XII cranial nerves and the other with transient ischemic cerebral accidents. In both cases the provisional diagnosis was made in function of the duplex findings of the supra-aortic trunks and confirmed by magnetic angioresonance studies. Both patients made satisfactory progress with complete recanalization of the vessels and no recurrence of symptoms after several months of follow-up. CONCLUSION: We discuss the different clinical characteristics and findings of the neurovascular examinations.
[Comparison of the effects of isoflurane and alfentanyl on the mononuclear-phagocytic system].
BACKGROUND AIMS: The effects of two anesthetic agents, alfentanil and isoflurane, on the macrophage-monocytic system and the relation with the adrenocortical-hypophyseal axis were analyzed. MATERIAL AND METHODS: Thirty ASA I-II patients submitted to elective surgery were distributed into two groups: group I, analgesic anesthesia with alfentanil 100 micrograms/kg, a perfusion of 2-3 micrograms/kg/min and naloxone 0.2-0.4 mg upon termination of surgery; group II, inhalation anesthesia with isoflurane at 2-2.5% and O2/air = 1/1. HLA-DR membrane receptors and vimentin threads of the cytoskeleton were determined in basal conditions, at one hour and two hours of induction and upon termination of surgery by means of indirect immunofluorescence with the use of monoclonal antibodies. Phagocytosis of latex particles was also measured and ACTH and cortisol levels were obtained by radioimmunoassay. RESULTS: In group I (alfentanil) a decrease (p < 0.01) of all the monocyte parameters analyzed, which was more significant than that observed in group II (isoflurane), was observed. In group II only the expression of HLA-DR and the index of phagocytosis (p < 0.05) were statistically significant. Following the administration of naloxone a reversion of these parameters was observed. The maximum immune depression corresponded with the lowest values of ACTH and cortisol (group I) with surgical stress being discarded as the cause of this immunodepression. CONCLUSIONS: Alfentanil produces a monocytic depression which reverses following the administration of naloxone, thus discarding surgical stress as the cause of this immunodepression suggesting a mechanism mediated by opiate receptors. With regards to isoflurane, the functions of the mononuclear-phagocytic system were hardly altered in the patient studied.
[The neurological care in area hospitals and specialized centers in the Valencian community in 1994. Commission of the Analysis of the quality of the SVN].
The law of Sevicio Valenciano de Salud which aim was to organize a new model of healthy care for Valencian Community (CV) coexists with care forms proceeding from the past model. This situation provides different matters to valencian neurologists. For that reason, the Comisión de Análisis de la Calidad de la Asistencia Neurológica de la Sociedad Valenciana de Neurologia, wanted to know the real situation of neurological care in Healthy Areas of Valencian Community and designed a questionnaire which aim was to obtain information on neurological care activity and the resources in each Healthy Area. This questionnaire was distributed to all neurologists who worked in each Area. The whole neurologists number of each Healthy Area. This questionnaire was distributed to all neurologists who worked in each Area. The whole neurologist number of Valencian Community in 1994 was 64 that means a rate of 1.66 neurologists per 100,000 inhabitants. Eighteen neuro-psychiatrists persist in 8 Healthy Areas. In the areas which included Central Hospitals, the rate was 2.1 Neurologists work in the hospitals, in Centros de Especialidades (ambulatory care) or in the two levels depending each Healthy Area, and the access of patient to neurological care varies taking into account the neurological working place. In the Centros de Especialidades, neurologists care a mean of 3,700 visits /year/100,000 inhabitants nearly and the mean visit time is 15 minutes. Ambulatory clinical records are different that records used in hospital but the care is similar. Neurologists depend to Medicine Service and realize admittance works in these services. The mean hospital neurological admissions are 250/100,000 inhabitants yearly and four Country Hospitals have specific beds for neurological patients. CT scan is not present in 5 hospitals, Duplex-Doppler in 12, EMG in 9, EEG in 9 and evoked potentials measurements in 11. Ten hospitals have not clinical neurophysiologist, 3 have not rehabilitation team, 7 have not neuropediatrics and there are not neurosurgery in any Country Hospital. The conclusions of this work includes: A low number of neurologists, the anachronic persistence of neuro-psychiatric care, the absence of homogeneous care organization and the insufficienct of neurological technics in most Healthy Areas in Valencian Community.
Subacute mucormycosis with secondary internal carotid occlusion: clinical and MR findings.
A case of subacute mucormycosis with a cavernous sinus syndrome and internal carotid occlusion with survival after surgical and anfothericin B treatment in a patient with type II diabetes is reported. The RM images of this form of evolution of the infection by mucormycosis is also described. We suggest that a mucormycosis with subacute profile is possible in a well controlled patient with an underlying inmunosuppressive disorder, and that this form of mucormycosis should be considered in the differential diagnosis of the destructive lesions of the middle line, as a prompt identification of this disorder can improve the survival rate of patients.