PubMed Health⌕ Search

Biomedical subjects

J González García

Publications and source records attributed to J González García.

18 recordsLinked to original sources

[ENT expression of hypohidrotic ectodermal dysplasia].

Hypohidrotic Ectodermal Dysplasia (HED) is a rare recesive genetic disease linked to chromosome X whose main characteristic is the reduction of sweat glands, leading to a deficient sweating and an increase in body temperature. In HED mainly the ectodermal structures are involved such, as epidermis and its anexes (hair and nails), although non-ectodermal tissue may also become involved. Otolaryngologicalmanifestations are related to hypoplasia of the mucous glands of the upper aerodigestive tract, as chronic infections, like rhinitis, pharyngitis, bronchitis and otitis, and also epistaxis, dysphagia, anodontia and, ozena, among others. A case of a young adult male affected with HED who is referred to the Otolaryngology Departament with a history of chronic pharyngitis and ozena, is presented and the literature reviewed.

Adult↗

[Prognostic factors of mortality during the episode of pneumonia due to Pneumocystis carinii in patients with HIV infection].

BACKGROUND: Despite a steady decrease in its incidence, pneumonia caused by Pneumocystis carinii (PCP) are still diagnosed, and they occur frequently in patients unaware of being infected with the human immunodeficiency virus (HIV). Since it is a disease with a high mortality risk, its early diagnosis and therapy would allow these patients to benefit from the advantages afforded Pneumocystis carinii, neumonía, infecciones oportunistas relacionadas con el sida, pronóstico.by anti-retroviral therapy. PATIENTS AND METHODS: Retrospective study, in which all adult HIV infected patients with microbiologically demonstrated PCP diagnosed at two tertiary-level hospitals in our country between 1985 and 1996 were included. The clinical records of patients were used as information source. The relative risks (RR) of death were estimated by the multivariant logistic regression. RESULTS: PCP was the first AIDS indicating disease in approximately 70 % of cases. Thirteen percent of patients died during the episode. Patients aged over 45 years had a death RR during the episode of 3.15 (95 % CI from 0.8 to 12.2); patients previously diagnosed of AIDS had a death RR of 3.4 (95 % CI from 1.3 to 9), and those with an alveolar-arterial oxygen gradient (pA-aO2) > 50 mmHg, a death RR of 3 (95% CI from 1.1 to 8). CONCLUSIONS: Factors independently related to survival to the PCP episode are age below 45 years, not to have had another AIDS indicating disease, and to have a pA-aO2 below 50 mmHg at diagnosis.

AIDS-Related Opportunistic Infections↗

[Predictive factors of non-compliance with anti-tuberculosis treatment in patients infected with the human immunodeficiency virus].

A study was conducted to know the rate of non-compliance of antituberculosis therapy among HIV-infected patients, the factors associated with non-compliance and the evolution of these patients. The therapy compliance in 276 tuberculous HIV infected patients diagnosed in two Madrid hospitals was analyzed. Fifty-one patients (18%) were not included in the analysis (6 died without therapy, 6 were lost and 39 died during therapy). Out of the 225 evaluable patients, 36 (16%, 95% CI, 11.6-21.6) did not comply with therapy. The only factor associated with a higher therapy non-compliance was the antecedent of drug use (20% of non-compliance; relative risk: 10, 95% CI, 1.4-71). Patients using drugs at tuberculosis diagnosis had higher risk for non-compliance (31%; RR, 3.1; 95% CI, 1.6-6.3). The incidence of tuberculosis reactivation after leaving therapy was 78.8/100 patient-years. Therapy non-compliance increased death risk associated with tuberculosis (RR, 9.8; 95% CI, 4.6-21). Programs for controlling antituberculous therapy should give priority to active drug users, as this is the group with the highest risk for non-compliance.

Adult↗

[New contributions to the study of chromophobe-cell renal carcinoma].

OBJECTIVE: The present study describes a case of the recently discovered chromophobe cell carcinoma of the kidney. Additional findings that have not been previously reported are presented and the importance of the clinical and anatomopathological diagnosis of this tumor type is underscored. METHODS: The tumor presented in a 72-year-old female with symptoms and signs that were not distinct from those of other more common renal tumors. She underwent a right radical nephrectomy. Histopathological, immunohistochemical and ultrastructural studies were performed and the findings were compared with those reported in the literature. RESULTS: The foregoing studies disclosed a chromophobe cell renal carcinoma, with some findings-chiefly ultrastructural-that have not been previously described. CONCLUSION: Chromophobe cell renal carcinoma, a tumor type that has recently been identified, is the subject of several studies that have been conducted to permit its clinical and anatomopathological characterization. The present study describes some observations which, to our knowledge, have not been previously described elsewhere.

Adenocarcinoma↗

[HIV infection in old age: an epidemiological and clinical study in 42 patients in the Community of Madrid].

A cross-sectional study was conducted at diagnosis of HIV infection in 42 patients aged > or = 60 years attended in two hospitals in the Madrid Community. Clinical and epidemiologic characteristics were retrospectively analyzed. Mean age was 64 years, 38 patients (90.4%) were males, and 24 (57.1%) met the AIDS criteria at diagnosis. Risk behaviour: 14 (33.3%) heterosexuals, 13 (30.9%) homosexuals, 3 (7.1%) bisexuals, 3 (7.1%) had received blood derivatives, 2 (4.7%) transfused patients, 1 (2.3%) parenteral drug abuser, 1 (2.3%) others and 5 (11.9%), unknown. In 18 (42.8%) patients there was a delay of diagnosis of 7.5 +/- 1.2 months (range: 1.5-24 months). These patients had lymphocyte counts lower than those diagnosed without delay (102 +/- 20 vs 262 +/- 67.10(9)/l, p < 0.01). Patients without AIDS criteria had a likelihood of 15.4% of progression towards AIDS at one year. The survival rate of patients with AIDS at one year was 50.1%. Patients with AIDS and diagnostic delay had a survival rate at one year lower than that in patients without diagnostic delay (30.7% vs 77.8%, p = 0.03). In summary, a predominant sexual transmission was found in our series. Delay of diagnosis entails a greater clinical and immunologic deterioration and a lower survival at one year. Early diagnosis and therapy with anti-retroviral agents might induce a longer survival in these patients.

AIDS-Related Opportunistic Infections↗

[Spectrum of the renal pathology in HIV infection: description of 85 autopsies and clinico-pathologic correlation].

A descriptive cross-sectional study was conducted on the prevalence and histologic characteristics of renal lesions found in the autopsies of 85 patients with HIV infection: also, a retrospective analysis of clinico-biological characteristics in 56 of these patients in order to establish the factors associated with the histological findings. A total of 85 autopsies were made from 1985 to 1993; 50 autopsies (58.8%) showed renal changes: 23 (27%) infections, 13 (15.2%) acute tubular necrosis (ATN), 6 (7%) tumors, 5 (5.8%) intersticial nephritis (IN), 5 (5.8%) nephrocalcinosis (NC), 10 (11.7%) others. In an additional study: group IIc (n = 37, study group with nephropathy) had a higher incidence in the hepatitis B surface marker (HBsAg) than in group Ic (n = 19, control group, without nephropathy) (0 vs 10, p < 0.05). The presence of disseminated mycobacteriosis in the autopsy was significantly higher in the group with nephropathy than in the group without nephropathy (11 vs 1, p < 0.05). No consistent data were observed between the clinical diagnosis of nephropathy and autopsic findings. In summary, a high incidence of nephropathy was found in the autopsies of HIV infected patients, although it was not previously suspected. Renal lesions in autopsies of HIV infected patients had a tubular-intersticial predominance over glomerular lesions. The use of potentially nephrotoxic drugs, the presence of HBsAG, and some opportunist infections apparently influenced on the development of renal lesions among these patients.

AIDS-Associated Nephropathy↗

[Waldenström's macroglobulinemia, cryoglobulinemia type I and membranous glomerulonephritis].

Renal complications in Waldenström's macroglobulinemia (WM) are infrequent and are characterized by the presence of PAS positive amorphous hyaline deposits in the capillary lumen, infiltrated with lymphoplasmatic cells with PAS positive inclusions in the interstices and intratubular hyaline cylinders. Membranous glomerulonephritis may be a paraneoplastic manifestation of the lymphoproliferative processes. A 67-year-old male was diagnosed of WM, type-I cryoglobulinemia with renal insufficiency without proteinuria. Renal histological examination revealed changes characteristic of nephropathy associated to WM as well as membranous glomerulonephritis. This association has not been described previously. The coexistence of two pathogenic mechanisms with a common base, lymphoproliferative disease, may explain this association.

Biopsy↗

[Bone marrow biopsy in myeloproliferative syndromes: prognostic value of cellular quantification].

The proportion of granulocytes, erythroblasts, immature cells and megakaryocytes was evaluated when revising the bone-marrow biopsy specimens of 36 patients with myeloproliferative syndromes. These proportions were compared between themselves, a so-called Z value being thus attained; such value resulted from summing the proportion of granulocytes, megakaryocytes and immature cells and subtracting the proportion of erythroblasts. According to its value, above or below the mean, the Z figure correlates with the survival, the difference between both groups appearing as statistically significant (p = 0.02).

Biopsy↗

[Evolution of exocrine function of the pancreas after acute pancreatitis. Prognosis factors].

Using the NBT-PBA test, we studied pancreatic exocrine function in two groups of patients: one group with acute pancreatitis of lithiasic origin that underwent cholecystectomy and other with pancreatitis of alcoholic origin. The test was performed at the time of the acute picture and later at one month, three months, six months and a year. Regardless of etiology, exocrine pancreatic function was always impaired after acute pancreatitis, no case showing recuperation at one month of the picture but some did at three months (64% of the lithiasis group and 25% of the alcoholic group). We also attempted to relate the recuperation of the exocrine pancreas with the amylase levels, leukocytosis and calcemia encountered in the acute phase. The only correlation found was a poorer and later recuperation in the patients with the lowest calcemia levels during the acute picture.

Acute Disease↗

[Ectopic Warthin's tumour in nasopharynx. Revision of one clinical case].

This is a case report of a 69-year-old male patient referred to the ENT out patients with right-sided epistaxis and hipoacusis. Fibroptic examination reveals a cystic lesion at the exit of the right eustachian. A CT scan is informed as a well delimited and rounded-shaped tumour compatible with lymphoma. Excisional biopsy by a nasal rigid endoscopy is practiced and the histology result is Warthin's tumour. The nasopharynx is a rather unusual location for this type of tumours, almost exclusive in origin of major salivary glands. It's highlighted the unforeseeable histological diagnosis in this particular anatomical region, where the clinical differential diagnosis is broad and the access difficult.

Adenolymphoma↗

[Intracranial ependymomas].

INTRODUCTION: Ependymomas are tumours derived from ependymal cells, found lining the cerebral ventricles and central canal of spinal cord. Intracranial ependymomas account for 2 6% of all neoplasms of the central nervous system and at least half present in the first two decades of life. DEVELOPMENT: We review the epidemiological, clinical, neuropathological details, neuroradiological aspects and treatment of intracranial ependymomas. CONCLUSIONS: Ependymomas of the posterior fossa predominate in children, while supratentorial tumours are more common in adults. This analysis of the literature further highlight that total tumour removal is the treatment of choice for intracranial ependymomas. Postoperative survival was predominantly dependent on the histological grade of malignancy, the extension of surgery and the age of the patient.

Brain Neoplasms↗

[Nasal rhinosporidiosis].

Rhinosporidiosis is a granulomatous disease of uncertain mycotic origin that is characterized by polypoid lesions, predominantly of the nasal mucous membrane and conjunctiva. It is endemic to India and Sri Lanki, but occasionally occurs in other regions of the world. We report a case in Spain. The modes of infection and transmission, as well as treatment, are discussed.

Adult↗