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J Gómez Cerezo

Publications and source records attributed to J Gómez Cerezo.

At least 19 recordsLinked to original sources
PubMed2006

[Endothelial dysfunction and vasculitis: a close relationship].

Endothelial dysfunction (ECD) is implicated in the etiopathogenesis of several entities, with special interest and new perspectives in collagen diseases and vasculitis. ECD precedes development of atherosclerotic coronary damage and thrombotic events, with accelerated atherogenesis. Mechanisms of ECD that are involved in vasculitis are not simply due to focal vascular inflammation, since it may be caused by inflammatory systemic mediators, for example C reactive protein and tumor necrosis factor (TNF) alpha. We already have preliminary studies about specific ECD treatment in vasculitis, with drugs such as anti-TNF.

Endothelium, Vascular↗
PubMed2005

[Cost-effectiveness of computerized axial tomography in the diagnosis of traditional clinical picture of fever of unknown origin].

Diagnostic strategy in fever of unknown origin has been changing in recent decades. The objective of this study is to define the role of thoracoabdominal computerized axial tomography in the first diagnostic stage. A sample of 24 patients with classical fever of unknown origin from our hospital Internal Medicine department was selected between January 1995 and December 2002. Cost-effectiveness of diagnostic thoracoabdominal computerized axial tomography compared to that of abdominal echography was analyzed; the information obtained with both diagnostic techniques for the final diagnosis was also evaluated. Computerized axial tomography contributed data suggestive of the diagnosis in 10 of 24 patients (41.7%); abdominal echography only gave orienting information to the diagnosis in 2 cases (8%). In 9 (90%) of the 10 patients with computerized axial tomography specific alterations, a conclusive definitive diagnosis (with analysis of biological sample) was possible. Accordingly, the use of this technique is justified at the beginning of the study of the classical fever unknown origin in order to orient the clinician to resort to other more directed and specific diagnostic techniques and with higher diagnostic cost-effectiveness.

Adolescent↗
PubMed2005

[Clinical-biological and radiological study of Wegener's granulomatosis in a university hospital].

UNLABELLED: Wegener's granulomatosis is a rare systemic vasculitis that fundamentally affects the kidney and respiratory tract. Although the histological findings are very characteristic, they do not occur in all cases, which makes diagnosis difficult. METHODS: The main clinical, biological and radiological characteristics of 13 cases of Wegener's granulomatosis diagnosed in a university hospital of the center of Spain are collected in this present paper. RESULTS: The majority of the patients were men in their 50's. Fever and general syndrome were usual presentations of the disease. Upper respiratory tract (10 cases) and lung involvement (9), followed by renal involvement (8), were the most common. Alveolar infiltrates and bilateral nodules were the most common findings in the X-ray and thoracic CT scan, although the latter permits a greater definition of the lesions. Measurement of antibodies against cytoplasma of the neutrophils (ANCA) was positive in 8 patients (6 cANCA and 2 pANCA). Renal biopsy was used most for the histologic diagnosis, where focal and segmental glomerulonephritis was the most common finding. The majority of the patients received steroids plus cyclophosphamide as induction treatment. CONCLUSIONS: Wegener's disease is a rare systemic vasculitis. The existence of hematuria or respiratory tract involvement in a patient with fever suggests the diagnosis. Conducting a CT scan and ANCAs measurement are useful tools for its diagnosis, since the histology is not definitive.

Adolescent↗
PubMed2003

[Diagnosis with helical CT and echocardiography of patients with suspected chronic thromboembolic pulmonary hypertension].

Chronic Thromboembolic Pulmonary Hypertension (CTEPH) is a serious disease with a very high mortality after variable periods of time. Early diagnosis of CTEPH is critical because thromboendarterectomy can improve survival, hemodimamics and functional capacity. Based on our experience we have performed a review of diagnostic techniques. Echocardiography, pulmonary angiography, fiberoptic angioscopy, helical CT an MRI. For each diagnostic procedure we have analysed its accuracy, invasiveness and easiness of use. We conclude that currently the most useful techniques are echocardiography (to asses pulmonary hypertension), and helical CT which is a good alternative to pulmonary angiography and can detect very specific findings such as dilatation of central pulmonary arteries, eccentric localized thrombi and mosaic attenuation of the pulmonary parenchyma. Even more accurate findings can be expected by the use of multislice CT, which could allow to asses the degree of narrowing of the pulmonary vessels and bronchial circulation.

Aged↗
PubMed2003

[Treatment of malignant pheochromocytoma with 131I MIBG: a long survival].

131I-metaiodobenzylguanidine (131I-MIBG) is a structural analogue of adrenal hormone norepinephrine employed to localise tumours derived of neural crest and in the treatment of malignant pheochromocytomas. Although the number of patients is low, in the revised literature there are objective remissions and reduction of hormonal activity, with symptomatic answers. However, the reduction of size of tumour only has been described in some times and hardly ever in the presence of osseous metastasis. We present one patient diagnoses of malignant pheochromocytoma with osseous metastasis, who was treated with 131I-MIBG. It was administrated a total dose of 1,800 mCu, with an excellent tolerance and short adverse symptoms. There were a partial tumour response and a complete hormonal response, with a survival of 30 years after the diagnoses.

3-Iodobenzylguanidine↗
PubMed2001

[Risk factors of a new cardio-embolic cerebral accident in non-valvular atrial fibrillation treated with acenocoumarol].

OBJECTIVES: To investigate the risk factors determining the appearance of a new cardio-embolic cerebral accident on secondary thrombophylaxis of non-valvular auricular fibrillation (NVAF). DESIGN: Controlled observational study on a series of patients treated with acenocoumarol for a period of 2.8 years. SETTING: Anticoagulation Unit of the La Paz Hospital and patients from Madrid Area 5. PARTICIPANTS: 172 patients with NVAF, over 55 and with fibrillation for at least a year, and who had suffered at least one ischaemic cerebral accident. All were treated with acenocoumarol and controlled at an INR of 2.5. The risk factors were determined and the appearance of new cardio-embolic phenomena was watched during the study period. MEASUREMENTS AND MAIN RESULTS: 12 cardio-embolic phenomena were recorded (11 CVA and one peripheral embolism). The univariate study showed there was a significant association between patients who suffered a new ictus and those who suffered heart failure (p < 0.05) and had a history of more than one ictus before the start of the study (p < 0.05). Multivariate analysis found that what had independent predictive value was having suffered more than one ictus. CONCLUSIONS: The greatest threat for developing a new ischaemic CVA during anticoagulation in NVAF is having a history of two or more previous ictus, as if the tendency to recur was due to these patients having more extensive atherosclerosis.

Acenocoumarol↗
PubMed2001

[Systemic necrotizing vasculitis in autopsy].

OBJECTIVE: To analyze the characteristics of systemic necrotizing vasculitis observed in necropsy emphasizing the non-diagnosed cases until necropsy and to identify the reasons of clinical confusion. MATERIALS AND METHODS: Necropsies of adult patients performed in Hospital General La Paz, Madrid, from 1966 to 1977 were reviewed. Clinical manifestations, analytical changes and involvement of different organs were analyzed. The correspondence degree between clinical and necropsic diagnoses was studied. RESULTS: A total of 18 cases of necrotizing vasculitis were observed out of 3,980 necropsies. The most common clinical manifestations were fever and general syndrome (60%). The organs most commonly involved were kidney (94%) and gastrointestinal tract (56%). Diagnosis was revealed by necropsy in 39% of cases; in these cases, the incidence of heart failure and peripheral neuropathy was significantly lower, whereas digestive hemorrhage and liver, pancreas, adrenal gland, and bladder involvement was significantly higher. CONCLUSIONS: Systemic necrotizing vasculitis in underdiagnosed, which can be partly explained by the lack of specificity of the most common symptoms and the paucity of characteristic clinical and organ-specific manifestations which leads to confusion with more prevalent conditions.

Adult↗
PubMed2000

[Churg-Strauss syndrome. Our experience in 2 decades].

BACKGROUND: Since 1951, the year when the Churg-Strauss syndrome was reported, several isolated cases have been reported in the literature but works containing a high number of cases are exceptional. The features of the syndrome as well as diagnostic criteria have not been contrasted in large series. We therefore tried to analyze these parameters in 16 patients diagnosed of Churg-Strauss syndrome at our hospital. METHODS: A retrospective analysis was made of 16 patients diagnosed of Churg-Strauss syndrome at Hospital Universitario La Paz from 1978 at 1998. Data regarding personal antecedents, clinical manifestations, analytical parameters, histology and clinical course were collected. Also, the main diagnostic criteria reported in the literature were applied to each case. RESULTS: Of the 16 cases, thirteen (81%) were women, six were diagnosed at an age between 21 and 40 years; other six cases from 51 to 70 years. All patients had antecedents of bronchial asthma. Among clinical manifestations, 60% had fever and 50% a general syndrome. The main involved organs by decreasing frequency were lung (100%), nervous system (63%), and heart (44%). The mean eosinophilic count was 7,640/mm3. The histological diagnosis was obtained in 14 out of the 16 patients (88%). The most efficient biopsies corresponded to muscle and nerve. After therapy, no relapse was noted of vasculitis although bronchial asthma persisted in most patients (12). Twelve cases (75%) fulfilled the Lanham diagnostic criteria. CONCLUSIONS: Churg-Strauss syndrome affects mainly women with severe eosinophilia. Electromyogram and muscle and peripheral nerve biopsy are useful tools for diagnosis. The Lanham criteria lead to the diagnosis in most patients.

Adolescent↗
PubMed1997

Pericardial tamponade as the first manifestation of adenocarcinoma.

We hereby report on 13 cases of pericardial tamponade as the first manifestation of an adenocarcinoma. The primary tumor was detected in 10 cases: 7 lung, 1 stomach, 1 breast and 1 thyroid. A first cytologic examination of the pericardial fluid yielded the diagnosis of adenocarcinoma in 10 cases, whereas a second cytology was needed in another two cases. The pericardial biopsy was positive in 7 out of 7 patients. The therapeutic procedures included pericardiocentesis in 9 patients (6 of whom had recurrent tamponade), a pericardial window in 4 and pericardiotomy in 4 (without recurrences). The mean survival was 4 months.

Adenocarcinoma↗
PubMed1997

[Nonbacterial thrombotic endocarditis: a review of a necropsy series].

Nonbacterial thrombotic endocarditis (NBTE) is characterized by the deposition of thrombi on undamaged heart valves and by the increased frequency of associated arterial embolic events in patients with chronic debilitating diseases. Fifteen subjects diagnosed by necropsy of nonbacterial thrombotic endocarditis (NBTE) were studied to evaluate the general features, associated diseases, arterial embolic events, distribution and characteristics of histologic lesions. The most common underlying disease was neoplasm, which was present in 10 cases. Of these, 6 were adenocarcinomas, 3 hematological, and the remaining case was a bladder carcinoma. Other associated diseases included amyloidosis, MELAS syndrome, and sepsis. In most cases peripheral arterial embolic events were detected (9 cases). The central nervous system and the lung were involved in 7 cases (78%), heart and kidneys in 5 cases (56%), and spleen in 4 cases (44%). Other involved organs included pancreas, thyroid gland, testicles, meninges, liver and adrenal glands. The left valves were predominantly involved. The mitral valve in eight cases and the aortic valve in six cases. All cases with right involvement had the antecedent of central venous catheterization. Subendothelial fibrosis was a common histological finding which revealed the chronicity of the disease.

Adolescent↗