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Biomedical subjects

J J Sebastián

Publications and source records attributed to J J Sebastián.

At least 19 recordsLinked to original sources
PubMed1997

Visceral leishmaniasis diagnosed by colonoscopy.

Zoonotic visceral leishmaniasis is common in western Mediterranean countries. A strong link between visceral leishmaniasis and human immunodeficiency virus (coinfection) has been proved, especially in Spain, which is an endemic area. This suggests that Leishmania may behave opportunistically. We report a case of colonic leishmaniasis in a 23-year-old Spanish woman infected with the human immunodeficiency virus.

AIDS-Related Opportunistic Infections↗
PubMed1997

Duodenal obstruction secondary to a metastasis from an adenocarcinoma of the cecum: a case report.

Metastatic tumors to the gastrointestinal tract are rare; the stomach and small bowel are the most common organs involved. Lung cancer, renal cell carcinoma, breast carcinoma, and malignant melanoma are the most common primary tumors metastatic to the duodenum. We report a metastasis to the duodenum from an adenocarcinoma of the cecum presenting as a duodenal obstruction 4.5 yr after the surgical resection of the primary tumor. The condition of the patient was temporarily controlled with the implantation of an endoduodenal metallic prosthesis as a palliative measure.

Adenocarcinoma↗
PubMed1997

[Sclerosing hepatocarcinoma not associated with hypercalcemia].

The sclerosing hepatocellular carcinoma is an unusual subtype of hepatocellular carcinoma characterized by an intense fibrous stroma in which the tubular structures are embedded. Histological diagnosis is difficult, and misinterpretation as cholangiocarcinoma or metastatic adenocarcinomas may occur. It usually presents on non-cirrhotic livers. Metastases located outside of the liver are frequent as well as hypercalcemia and low levels of serum phosphate. We report a case of this rare histopathologic subtype of hepatocellular carcinoma in a 35-year-old woman, asymptomatic and with no previous history of chronic liver disease. It was detected by a routine gynaecological ultrasonography. An important increase of serum alpha-fetoprotein was noted. Extension studies showed bilateral lung metastases. Several palliative therapies were tried out, including epirrubicin, with partial response. Twenty months after the diagnosis the patient's situation is nearly terminal.

Adult↗
PubMed1996

[Diffuse gastrointestinal angiodysplasia associated with cryptogenic hepatic cirrhosis and coagulopathy simulating von Willebrand disease].

Angiodysplasic lesions can be located anywhere in the gastrointestinal tract, but most of them are found in the cecum and right colon. Angiodysplasias are very infrequent in the stomach and small bowel. These lesions can be associated with several clinical conditions, such as certain coagulation disorders and liver diseases. We report the case of a diffuse gastrointestinal angiodysplasia in a female patient with idiopathic cirrhosis of the liver who developed a coagulopathy which mimicked von Willebrand disease. After repeated blood transfusions, which were not able to control the anemia of the patient, an antrectomy was performed because most lesions were located in the antrum. The procedure did not achieve a suitable control of the bleeding. Finally, a hormonal therapy combining estrogens and progestagens, was able to control, at least partially, the patient's chronic gastrointestinal bleeding.

Aged↗
PubMed1995

[Primary gastric lymphoma in an HIV positive patient].

We report the case of a young male patient, VIH (+), who was admitted in our hospital with severe epigastric pain. Endoscopical and histological diagnosis was primary gastric non-Hodgkin lymphoma without Helicobacter pylori. The patient was treated with chemotherapy by CHOP scheme (6 cycles), with high clinical improvement and endoscopical and histological regression of the lesion. We comment some features of this peculiar association.

Adult↗
PubMed1995

[Epithelioid hemangioendothelioma: a rare hepatic tumor].

We present a case of epithelioid hemangioendothelioma of the liver (EHL). The imaging techniques did not permit the diagnosis. A liver biopsy was done under laparoscopy. One year later, the patient remains without symptoms in spite of the presence of lung metastases and the therapeutic abstention. The most outstanding aspects of this rare hepatic tumor are discussed.

Adult↗
PubMed1994

[Omeprazole and cimetidine in the treatment of upper digestive hemorrhage].

AIM: To compare the efficacy of omeprazole (40 mgs/12 h i.v.) and cimetidine (1,200 mgs/i.v./day) in the management of upper gastrointestinal bleeding. EXPERIMENTAL DESIGN: Randomized, prospective open clinical trial. The end points are: mortality, surgical requirements, transfusion requirements, and length of hospitalization in Bleeding Unit and Hospital. PATIENTS: We study patients with upper gastrointestinal bleeding from peptic sources (duodenal ulcer, gastriculcer, acute gastric erosions and peptic esophagitis). 462 patients are evaluated and 282 finally included. RESULTS: 151 patients were given cimetidine and 131 omeprazole. No significant differences in any of the end points were found. CONCLUSIONS: The use of omeprazole does not improve cimetidine efficacy in the entire group of patients with upper gastrointestinal bleeding.

Cimetidine↗
PubMed1994

[The endoscopic management of postoperative biliary fistulae].

We report a series of 15 patients with a postoperative biliary fistula treated by endoscopic sphincterotomy. The exact location of the bile leak was revealed by ERCP in 13 cases (87%): cystic duct remnant in 6 (39%), intrahepatic biliary tree in 4 (26%), and main bile duct in 3 (20%). In all cases a distal obstacle (ie: retained stones, hydatid material) to bile flow was also found in ERCP. Treatment consisted of endoscopic sphincterotomy and subsequent removal of the distal obstacle, and could be completed in 13 (87%) cases. In our experience the treatment of postoperative biliary fistula with a distal obstruction bile flow by endoscopic sphincterotomy is a safe and effective procedure, and should be recommended as the first option in those patients.

Adult↗
PubMedDate not supplied

[Severe massive pseudomembranous colitis with a fulminant course].

Pseudomembranous colitis is an inflammatory disease of rectal and colonic mucosa caused by Clostridium difficile produced toxin. The inflammation is produced as the consequence of a non-specific response to several agents. It usually presents with abdominal pain and mild watery diarrhea which used to decrease when removing the antibiotic or when starting the therapy with metronidazole or vancomycin. In aged patients, with severe concomitant diseases, may appear complications such as dehydration, electrolyte imbalance, hypotension and toxic megacolon, which occasionally may lead to fatal outcome. We report the case of a severe pseudomembranous colitis, with a fulminant clinical course, in a patient without a recent antibiotic therapy.

Aged↗