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Biomedical subjects

J Ferreirós

Publications and source records attributed to J Ferreirós.

12 recordsLinked to original sources
PubMed2000

[Localization of lung nodules with CT-guided hookwire before videothoracoscopic surgery].

PURPOSE: To localize peripheral lung nodules under CT guidance using hookwires, prior to video-assisted thoracic surgery (VATS). PATIENTS AND METHODS: Twenty-two pulmonary nodules were localized with a hookwire under CT guidance. The visceral pleura was stained with methylene blue. VATS was performed thereafter. RESULTS: All nodules were successfully localized and resected without significant complications. CONCLUSIONS: In select cases, localization of pulmonary nodules with hook wire and methylene blue allows the thoracoscopic resection of unaccessible lesions.

Adult↗
PubMed1999

Magnetic resonance imaging in the evaluation of inflammatory lesions in muscular and soft tissues: an experimental infection model induced by Candida albicans.

We have developed an experimental model to monitor inflammatory lesions in muscle and soft-tissues during the different stages of the disease by means of Magnetic Resonance Imaging (MRI). MRI of mice legs infected with Candida albicans was performed by standard two-dimensional spin echo and fast spin echo (RARE) using customized coils. The MRI findings were compared with pathologic examinations at the initial acute and established acute inflammatory stages, which provided accurate and detailed information on the evolution of the processes involved. The yeast caused inflammation within the first hours post-inoculation, appearing on T2-weighted images as an inhomogeneous mass with increased signal intensity. The presence of fungal hyphae was observed as hypointense signal areas in both T2 and T1 weighted images, with histologic confirmation. Areas of decreased signal intensity on T2 weighted images were apparent on the last experimental day and were attributed to the granulation tissue located within the capsule surrounding the abscess. The close correlation found between MRI and histopathology suggests that MRI is an ideal radiologic technique for monitoring the clinical and therapeutic follow-up of fungal infections in muscle and soft tissues.

Animals↗
PubMed1999

Transthoracic needle aspiration biopsy: value in the diagnosis of mycobacterial lung opacities.

The purpose of this study was to assess the value of transthoracic fine-needle aspiration in the diagnosis of mycobacterial infection as the cause of focal lung opacities. Six hundred twelve fine-needle aspiration biopsies were performed from 1985 to 1997 in 587 patients with solitary or multiple lung opacities. Initial procedures, including sputum analysis and bronchoscopy, had been nondiagnostic. Fluoroscopic or computed tomography guidance was used, and a pathologist was present. A diagnosis of mycobacterial infection was established when acid-fast bacilli were demonstrated in the aspirate. In 487 patients, a malignant cause was confirmed, and six other patients had carcinoid tumor. Of 94 nonmalignant opacities, 24 (26%) were determined to have a mycobacterial cause. Fine-needle aspiration biopsy detected acid-fast bacilli in 15 of 24 cases (sensitivity, 62.5%; specificity, 100%). Radiologic findings included upper lobe involvement (17 of 24 cases), single opacities (12 of 24 cases), satellite nodules (4 of 12 cases with single opacities), irregular borders (19 of 24), eccentric calcification (2 of 24), and cavitation (8 of 24). The authors conclude that fine-needle aspiration biopsy must be processed for acid-fast bacilli when nonmalignant cytologic findings result, even if the results of sputum smears, cultures, and bronchoscopy are negative.

Adolescent↗
PubMed1998

Supravalvular aortic stenosis in aortic dissection.

Supravalvular aortic stenosis is a rare complication of aortic dissection. We report on echocardiographic and magnetic resonance observations in 2 cases of aortic dissection with false lumen thrombosis of the ascending aorta and severe narrowing of the true lumen.

Aged↗
PubMed1998

Penetrating atherosclerotic aortic ulcer: documentation by transesophageal echocardiography.

OBJECTIVES: This study sought to describe the ability of transesophageal echocardiography (TEE) to document the presence of penetrating atherosclerotic aortic ulcers and their complications. BACKGROUND: TEE has greatly enhanced our ability to assess patients with suspected aortic disease. However, the utility of this technique in the diagnosis of penetrating atherosclerotic aortic ulcers is still undefined. METHODS: TEE was performed prospectively in 194 patients to evaluate aortic disease. Twelve patients with the diagnosis of aortic ulcers or their complications were specifically studied. The diagnosis was confirmed by pathologic studies in six patients and by an additional diagnostic technique (angiography, computed tomography or magnetic resonance imaging) in the other six. All 12 patients were hypertensive and presented with chest or back pain; the mean age was 65 years (range 56 to 79). The initial working diagnosis was acute aortic dissection in nine patients. Aortic ulcers were located in the descending thoracic aorta in eight patients, the aortic arch in two and the ascending aorta in two. RESULTS: TEE could detect aortic ulcers or their complications in 10 patients but failed to detect these lesions in the remaining 2 (1 with aortic ulcers in the distal ascending aorta and 1 with aortic ulcers in the aortic arch). In four patients, aortic ulcers were detected as a calcified focal outpouching of the aortic wall and were associated with concomitant aneurysmal dilation of the aorta in two patients and with a small localized intramural hematoma in one. TEE visualized a partially thrombosed pseudoaneurysm complicating an aortic ulcer in the descending thoracic aorta of two patients. Four patients had an aortic ulcer complicated by a "limited aortic dissection" in the descending aorta that could be detected by TEE. Five patients underwent operation, two because of aneurysmal dilation of the aorta and three because of aortic dissection; two patients died of aortic rupture; the remaining five did well (11-month follow-up) without operation. CONCLUSIONS: Aortic ulcers should be included in the differential diagnosis of chest or back pain, especially in elderly hypertensive patients. These ulcers and their complications may be recognized by TEE.

Aged↗
PubMed1997

Aortic dissection occurring during coronary angioplasty: angiographic and transesophageal echocardiographic findings.

A localized acute aortic dissection was produced in 2 patients, complicating coronary angioplasty. In both cases a coronary dissection provided the entry door, with subsequent retrograde progression of the dissection into the aortic root. After sealing the entry door, both patients could be managed conservatively using transesophageal echocardiography to accurately define the location of the intimal flap and to rule out dissection progression.

Aged↗
PubMed1997

Natural history and serial morphology of aortic intramural hematoma: a novel variant of aortic dissection.

BACKGROUND: Acute aortic dissection is a cardiovascular emergency that requires prompt diagnosis and treatment. Transesophageal echocardiography is the current standard diagnostic imaging modality in many medical centers. Aortic intramural hematoma is a variant of aortic dissection whose natural history and prognosis have not been well studied. We performed transesophageal echocardiography in patients with aortic intramural hematoma to determine the echocardiographic characteristics and echocardiographic evolution of this lesion, impact on patient management, and patient outcome. METHODS AND RESULTS: Twenty-one consecutive patients with aortic intramural hematoma confirmed anatomically (four patients) or with an additional diagnostic imaging technique (17 patients) underwent a transesophageal echocardiographic examination. Fifteen patients with longstanding hypertension had chest or back pain, and the intramural hematoma was visualized in the ascending aorta (n = 4), along the whole aorta (n = 4), in the descending aorta (n = 6), or in the aortic arch (n = 1). The thickening of the aortic wall was crescentic. Patients with ascending aortic intramural hematoma had the following results: two patients died suddenly, three patients underwent surgery because of increased aortic wall thickening (one patient) or secondary intimal tear (two patients), and the remaining three patients had regression of the hematoma. Patients with hematoma confined to the descending aorta and the patient with aortic arch involvement (n = 7) had a different result: one patient died from aortic rupture and the remaining six patients did well. Six patients had a traumatic aortic injury, and the intramural hematoma was located along the descending thoracic aorta. The thickening of the aortic wall was circular in five patients and crescentic in one. Three of these patients had normalized thickness of the aortic wall on follow-up transesophageal echocardiographic studies. The other three patients died from multiorgan system failure. Aortography showed a reduction of the diameter of the aortic lumen in four patients; diameter in the remaining 17 patients was normal. CONCLUSIONS: Aortic intramural hematoma can be detected and monitored by transesophageal echocardiography but not by aortography. Two types of aortic intramural hematoma can be distinguished: (1) traumatic of good prognosis and (2) nontraumatic, which can be an early stage of the classic aortic dissection, with bad prognosis in cases involving the ascending aorta.

Adult↗
PubMed1996

[Identification of intramural aortic hematoma by transesophageal echocardiography].

BACKGROUND AND AIM: The usefulness of transesophageal echocardiography in the diagnosis and assessment of patients with aortic dissection has been widely demonstrated. The aim of this study was to evaluate the role of this technique in the detection of intramural aortic hematoma and in the follow-up of these patients. METHODS: The records of 51 patients with aortic dissection by transesophageal echocardiography diagnosed between May 1990 and May 1994 were reviewed. RESULTS: The diagnosis of intramural aortic hematoma was established in 6 patients by transesophageal echocardiography (11%). This diagnosis was confirmed either anatomically (3 patients) or with an additional diagnostic technique (computed tomography or magnetic resonance imaging) and on the basis of echocardiographic follow-up changes (3 patients). CONCLUSIONS: Intramural aortic hematoma represents an infrequent variant of aortic dissection that can be detected by transesophageal echocardiography and is usually unrecognized by aortography.

Adult↗
PubMed1991

[Bacteremia caused by Streptococcus pneumoniae and HIV infection].

We analyze seven patients with HIV infection that developed community-acquired bacteremic pneumonia due to Streptococcus pneumoniae. Six patients were drug addicts and one was a male homosexual. Five patients have been previously diagnosed of having AIDS. All patients had fever with respiratory tract symptoms and abnormal X-ray films of the chest, in five cases the lesions were located in both lungs. Only four patients showed a pattern of consolidation. The remaining cases showed an interstitial pattern. All but one patient have a CD4 lymphocyte count equal or less than 50 cells/mm3. Clinical evolution was good with antibiotic treatment. In two cases a relapse occur. No deaths were seen directly related to pneumococcal infection. We want to highlight the relative lack of severity of this infection and we suggest the use of antibiotic treatment for at least 14 days.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Hydatid disease: radiologic and pathologic features and complications.

Hydatid disease primarily affects the liver and typically demonstrates characteristic imaging findings. However, there are many potential local complications (eg, intrahepatic complications, exophytic growth, transdiaphragmatic thoracic involvement, perforation into hollow viscera, peritoneal seeding, biliary communication, portal vein involvement, abdominal wall invasion). Furthermore, secondary involvement due to hematogenous dissemination may be seen in almost any anatomic location (eg, lung, kidney, spleen, bone, brain). Ultrasonography (US) is particularly useful for the detection of cystic membranes, septa, and hydatid sand. Computed tomography (CT) best demonstrates cyst wall calcification and cyst infection. CT and magnetic resonance (MR) imaging may demonstrate cyst wall defects as well as the passage of contents through a defect. Chest radiography, US, CT, and MR imaging are all useful in depicting transdiaphragmatic migration of hydatid disease. CT is the modality of choice in peritoneal seeding. US and CT demonstrate rupture in most cases that involve wide communication. Indirect signs of biliary communication include increased echogenicity at US and fluid levels and signal intensity changes at MR imaging. CT allows precise assessment of osseous lesions, whereas MR imaging is superior in demonstrating neural involvement. Familiarity with atypical manifestations of hydatid disease may be helpful in making a prompt, accurate diagnosis.

Bone and Bones↗
PubMedDate not supplied

Computed tomography in abdominal Castleman's disease.

Three patients with abdominal Castleman disease studied by CT are presented. Two cases corresponded to localized mesenteric disease and the third to a systemic form of the process. The CT findings are nonspecific, although a dense enhancement of the lesions can be demonstrated sometimes on dynamic CT.

Adult↗