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Biomedical subjects

J Cervantes

Publications and source records attributed to J Cervantes.

At least 19 recordsLinked to original sources
PubMed2001

Choledocholithiasis: new approach to an old problem.

The old problem of diagnosis and treatment of choledocholithiasis is analyzed in light of recent developments in the field of radiology and surgery. The traditional indications for common bile duct (CBD) exploration resulted in a large number of unnecessary manipulations of the bile ducts. The same is now true of the widespread use of endoscopic retrograde cholangiopancreatography. With the advent of magnetic resonance imaging cholangiography, which can clearly demonstrate CBD calculi by means of a noninvasive, complication-free technology, we should abandon the old indications for CBD exploration and be more conservative regarding the diagnosis and management of this condition. In an era of minimally invasive surgery we are seeing a significant reduction in the number of patients with choledocholithiasis.

Cholangiography↗
PubMed1999

A study of adult T-cell leukemia/lymphoma incidence in central Brooklyn.

Adult T-cell leukemia/lymphoma (ATL), a rare outcome of infection with human T-lymphotropic virus (HTLV-I), is endemic in central Brooklyn, which has a large Caribbean migrant population. Previous studies have suggested that HTLV-I prevalence in central Brooklyn may be similar to that recorded in the Caribbean islands. We established a pilot 1-year surveillance program to identify cases of ATL in 7 of 10 hospitals serving the residents of 18 zip codes of central Brooklyn with a combined population of 1,184,670. Of the 6,198 in-patient beds in the catchment area, approximately 83% were covered. Twelve incident cases of ATL were ascertained, all among persons of Afro-Caribbean descent, indicating an annual incidence in African-Americans in this community of approximately 3.2/100,000 person-years. Unexplained hypercalcemia was the most useful screening method, identifying 3 of 5 patients not referred for possible ATL by a local hematologist. The female:male ratio was 3:1. The age pattern was different from that reported in the Caribbean Basin and closer to the pattern seen in Japan. Our study supports evidence that HTLV-I infection and ATL are endemic in central Brooklyn and suggests that a more intensive surveillance program for this disease coupled with intervention efforts to reduce HTLV-I transmission are warranted.

Adult↗
PubMed1999

Laparoscopic common bile duct exploration.

Since the introduction of laparoscopic cholecystectomy, the management of common bile duct (CBD) stones has undergone significant change. Preoperative endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy is now routinely done in cases where the diagnosis of choledocholithiasis is suspected preoperatively, with clearance of the bile ducts before laparoscopic cholecystectomy. Intraoperative discovery of CBD stones by cholangiography represents a challenge to the surgeon, who must make a decision about when to perform laparoscopic CBD exploration, convert to open surgery, or send the patient for ERCP during the postoperative period. Because ERCP has a definite failure rate, laparoscopic CBD exploration can be a treatment option. Among 2500 laparoscopic cholecystectomies done by our group from January 1991 to June 1997, 50 patients (2%) underwent laparoscopic CBD exploration, 13 by the transcystic technique and 37 by choledocotomy, with a conversion rate of 8% and a hospital stay of 4.3 days. One patient died from complicated pancreatitis following ERCP and unsuccessful extraction of a CBD stone. We obtained our goal of a CBD free of stones in 92% of the cases. We conclude that laparoscopic CBD exploration is an effective method for treating choledocolithiasis that allows management of this pathology in one stage, although it requires advanced laparoscopic skills and adequate equipment.

Adult↗
PubMed1999

Application of 29Si and 27Al magic angle spinning nuclear magnetic resonance to studies of the building materials of historical monuments.

We report the application of 29Si and 27Al magic angle spinning nuclear magnetic resonance (MAS NMR) studies on building stones from historical monuments to obtain direct information about the degree of degradation and to observe the changes in the consolidated material after treatment with tetraethoxysilane (TEOS). Using the data obtained from deteriorated materials, a diagnostic laboratory, a suitable treatment and recommendations for building conservation may infer. A case study is presented using stones from Guanajuato City Main Church (Central Mexico). X-ray diffraction patterns to characterize the species present in the stones agree with the solid state NMR results.

Aluminum↗
PubMed1999

[Acoustic voice analysis in phonatory fistuloplasty after total laryngectomy].

A comparative study was made of the voices of three groups of male patients by acoustic analysis of sustained phonation of the vowel /a/: 1) 20 patients who had undergone total laryngectomy and phonatory fistuloplasty, fitted with a Herrmann voice prosthesis, who had achieved successful prosthetic speech; 2) 20 laryngectomized patients with good quality esophageal speech, and 3) 20 subjects with normal voices. Statistical analysis of fundamental frequency disclosed significant differences between groups, the group with phonatory prostheses having the closest to normal voice of the fistuloplastic groups. There were no statistically significant differences in jitter, shimmer, and the harmonic-to-noise ratio between the esophageal and prosthetic voice groups, which suggests that the disturbances in the vibratory esophageal ring were similar.

Adult↗
PubMed1997

Changes in gallbladder surgery: comparative study 4 years before and 4 years after laparoscopic cholecystectomy.

Operative procedures on the gallbladder and biliary ducts have undergone a profound transformation since the introduction of laparoscopic techniques in general surgery. As the benefits of minimally invasive procedures become universally known, patients are seeking surgery at an earlier stage, resulting in an increased number of cases for elective surgery and a considerable reduction in emergency operations, morbidity, need for intraoperative cholangiography (IOC), fewer common bile duct (CBD) explorations, shortened hospital stay, and reduced overall costs. The early criteria for IOC and the need for CBC explorations must be reevaluated in view of the observed changes and appropriate modifications made. Looking at the present trends, it seems that the routine use of IOC is not justified in the average patient who presents for laparoscopic cholecystectomy with no history of jaundice or pancreatitis, normal liver function tests, and a normal-size CBD on ultrasonography. Under those conditions, the chance of leaving an unsuspected stone in the CBD is less than 1%; and if it happens the stone can be easily retrieved by endoscopic sphincterotomy as an outpatient procedure.

Cholangiography↗
PubMed1995

Unilateral polycystic (dysgenetic) disease of the parotid gland.

We report a case of unilateral polycystic disease of the parotid gland. Only eight cases of this disease have previously been published in the English language literature, and seven of them were bilateral. Thus, we are reporting the second case of unilateral involvement. The disease is apparently limited to the parotid gland and to women. Clinically, a fluctuating, long-standing, nontender parotid gland swelling is usually noticed in adulthood. Histologically, there are numerous epithelial-lined cysts, which appear to be derived from intercalated ducts. This disease probably represents a developmental condition.

Actins↗
PubMed1994

Intrahepatic subcapsular biloma. A rare complication of laparoscopic cholecystectomy.

Bile leaks leading to bilomas in the subhepatic space are amongst the most common complications of laparoscopic cholecystectomy (LC). We describe the case of a large (1,100 cc) intrahepatic biloma that presented with pain and fever 14 days post LC. The diagnosis was suspected as a result of ultrasound and CT scan and the problem was solved by percutaneous catheter drainage. We believe this intrahepatic biloma was caused by a lesion of an abnormal bile duct near the bed of the gallbladder during a difficult dissection due to severe contraction and fibrosis.

Bile↗
PubMed1994

An enhanced surveillance program for adult T-cell leukemia in central Brooklyn.

The Brooklyn Adult T-cell Leukemia/Lymphoma (ATL) study was developed to estimate the incidence of the human T-cell lymphotropic virus type I (HTLV-I)-associated ATL in the Crown Heights/Bedford Stuyvesant community. This central Brooklyn black community is an area which has already been shown in earlier reports to be endemic for HTLV-I-associated ATL. Surveillance has been conducted at seven area hospitals that serve this community, with surveillance already completed at five hospitals. Potential study subjects who are 20 years or older are identified by the review of admission records, discharge summaries, pathology and clinical chemistry reports, or physician referrals. Diagnoses of leukemia or lymphoma, or the presence of leukocytosis or hypercalcemia are used as criteria to identify the subjects. Participating subjects give a sample of blood for the determination of HTLV-I infection by serologic tests. At the time of enrollment, subjects provide demographic information including age, sex and birthplace. After one year of surveillance at five hospitals (39.5% of inpatient beds in the catchment), we have identified 12 cases of HTLV-I-associated ATL. The mean age of the ATL patients was 50 years, with patients being predominantly female (83.3%) and often Caribbean immigrants (83.3%). Interestingly, 42% of our cases were identified solely by findings of hypercalcemia from clinical chemistry reports. The remaining ATL cases were identified by physician referral. This enhanced surveillance program that uses both clinical and laboratory criteria for ATL case ascertainment can serve as a prototype for similar surveillance in other areas endemic for HTLV-I-associated ATL--an important effort because of the strong potential for disease prevention.

Adult↗
PubMed1992

[Laparoscopic cholecystectomy in pediatrics. A report of the first case in the Mexican literature].

The authors present the case of a 9.8-year-old girl with 5 a month history of epigastric pain which was due to gallstones as demonstrated by ultrasound. After an extensive work-up failed to reveal associated hematologic problems, she was successfully treated by laparoscopic cholecystectomy, resulting in complete recovery, hospitalization of 22 hours and return to school three days after major surgery. We could not find references of laparoscopic cholecystectomy in the pediatric age group in the Mexican literature and only 3 in English language publications. In cases of cholelithiasis without associated diseases in children, the operation of choice should be laparoscopic cholecystectomy.

Child↗
PubMed1986

Measurement of gastric emptying rate in humans by real-time ultrasound.

Simultaneous studies of gastric emptying by ultrasound and scintigraphy were performed in 14 subjects to assess the use of ultrasound for the measurement of gastric emptying rate. The presence of air in the stomach prevented the acquisition of gastric emptying data by ultrasound in 3 of the 14 subjects. In the remaining 11 subjects there was no significant difference between values for the half-time (t1/2) of gastric emptying obtained by scintigraphy [for anterior imaging, mean t1/2 = 20.9 +/- 9.9 min (+/- SD); for anterior and posterior imaging, geometric mean t1/2 = 21.1 +/- 10.5 min (+/- SD)] compared with those derived by ultrasound [mean t1/2 = 20.2 +/- 10.0 min (+/- SD), p greater than 0.05 for each comparison]. A significant correlation between the t1/2 of gastric emptying derived by scintigraphy (anterior scanning and geometric mean of counts obtained by anterior and posterior scanning) and the t1/2 measured by ultrasound was obtained (r2 = 0.7, 0.69, respectively). These results imply that ultrasound can be used for the valid assessment of the gastric emptying rate in humans.

Adult↗
PubMed1983

Ultrasound diagnosis of rectus sheath hematoma.

The authors present three patients with rectus sheath hematoma who were diagnosed with ultrasound and successfully operated upon. The importance of a correct preoperative diagnosis is stressed to avoid an unnecessary laparotomy. Ultrasound helps to localize the presence of an extra-abdominal mass located between the aponeurotic sheaths of the rectus muscle. Surgery is the best treatment since it is possible to evacuate the large hematoma, and at the same time it affords an opportunity to ligate the bleeding vessels, usually the epigastrics. No advantage is seen using conservative treatment, as several weeks may be necessary before complete resolution, while the patient is suffering considerable pain and discomfort.

Abdominal Muscles↗
PubMed1981

Fluphenazine decanoate and tardive dyskinesia: a possible association.

The authors examined the charts of 22 outpatients who had received intramuscular fluphenazine decanoate and oral fluphenazine hydrochloride to assess the incidence of tardive dyskinesia. The severity of tardive dyskinesia was assessed with the Abnormal Involuntary Movement Scale (AIMS). Both the total dose and average daily dose of fluphenazine decanoate correlated significantly with high AIMS scores. There were also significant correlations of AIMS scores with total dose of antiparkinsonian medication and total dose of other neuroleptics. Total dose of antiparkinsonian medication correlated with total dose of fluphenazine decanoate. The authors discuss the clinical and physiological implications of these correlations.

Adult↗
PubMedDate not supplied

Health care delivery system. Effects on surgical education: the Mexican panorama.

Health care delivery in Mexico is divided in three groups: a social sector that covers approximately 53% of the population and is financed by the labor force, the state and the employer; a public, or open, sector that covers 33% of the population and is financed by federal and state funds; and a private sector that covers about 5% of the population and has two categories, the not-for-profit hospitals and the profit-oriented institutions. Most medical practitioners can work in any of the three groups or in several. Nine percent of Mexico's population, because of extreme ignorance, poverty, or isolation, have no or limited access to medical care. Mexico has 58 medical schools, which graduate about 7800 new physicians annually, awarding them the title Medico Cirujano (Physician Surgeon). There are more than 160,000 physicians in Mexico, 20,000 of whom are unemployed. Each year, approximately 12,000 physicians compete for the 4306 places in the official residency training programs for all specialties. Of those taking the examination, 2000 try to get one of the 625 slots available for training in general surgery. Most of the surgical training programs in Mexico have a 3-year duration. The Mexican Academy of Surgery, the Mexican Society of General Surgery, and the Mexican Board of Surgery, as well as private individuals and organizations, are working to improve the quality of medical education and trying to establish a 5-year training program in surgery. The rapid movement toward modernization that is sweeping the country must include the improvement of surgical education as well.

Delivery of Health Care↗
PubMedDate not supplied

[Diagnosis and prevalence of arterial hypertension in persons under 19 years of age in the city of Colima].

OBJECTIVE: To assess the prevalence of high blood pressure among young children. MATERIAL AND METHODS: This is a cross-sectional study, conducted in 1992 in Colima City, Mexico. Blood pressure readings were obtained from 400 children aged under 19. Statistical analysis consisted of calculation of means, variance, and Anova by group age. Association between age and blood pressure was assessed with correlation and determination coefficients. Comparisons by sex were made using Student's t, F, Mann-Whitney's U, and Z tests. Percentile 95th was used to define normal figures. RESULTS: A lineal correlation coefficient was found and confirmed by the determination coefficient. Groups where this association was statistically significant at p < 0.01 were: a) children aged under 2; b) children from 2 to 13 years of age; and c) those over 13 years of age. High blood pressure figures for each group were: a) 92/50 mm/Hg; 110/70 mm/Hg; and 133/84 mm/Hg, respectively. CONCLUSIONS: The prevalence of high blood pressure in younger children may be 8% for systolic pressure and 9% for diastolic pressure.

Adolescent↗