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J Lázaro

Publications and source records attributed to J Lázaro.

15 recordsLinked to original sources

Analysis of the complications of the piggy-back technique in 1,112 liver transplants.

BACKGROUND: The "piggy-back" technique has gained acceptance in adult orthotopic liver transplantation during the last few years, especially in European countries. At the moment, however, there is controversy over advantages or specific complications (suprahepatic thrombosis or narrowing, etc.) related to this surgical technique. The aim of this study is to know of the immediate per-and postoperative morbidity and mortality rates in 1112 orthotopic liver transplantations performed with a vena cava preservation technique. METHODS: All liver transplant units in Spain were sent a questionnaire on retrohepatic vena cava preservation during orthotopic liver transplantation. The number of orthotopic liver transplantations that had been performed in the seven centers that answered the questionnaire, because the beginning of the program, was 1674, with the vena cava preservation technique used in 1112. RESULTS: Twenty-eight patients (2.5%) had intraoperative complications related to the vena cava preservation technique, which were treated during the operation. Eleven patients (1%) had early postoperative complications (first week), the most frequent (nine cases) being an acute Budd-Chiari syndrome in the first 48 hr. Three patients developed symptoms of massive ascites between 2 and 3 months (late postoperative complications), with patency of the retrohepatic cava verified by cavography. A hemodynamic study revealed a hyperpressure at the suprahepatic veins. This chronic Budd-Chiari syndrome was controlled in all patients with diuretics. Only six patients (0.5%) died as a result of complications related to the "piggy-back" technique. These complications were more frequent when venous reconstruction was done using two suprahepatic veins than when the three veins were used (P<0.001). CONCLUSIONS: The vena cava preservation technique can be used routinely in orthotopic liver transplantation because it is safe and efficient and involves few surgical complications especially if for venous reconstruction we use the patch obtained by joining the three suprahepatic veins.

Adult↗

The concept of 'delusion' in Spanish psychiatry.

The history of the concept of delusion can be used to explore the general history of psychiatry in Spain and assess the contribution of her most distinguished practitioners. As this paper shows, the latter have not been as creative as their fellow artists or writers. Nonetheless, the ideas on delusions that some of them formulated deserve attention. The history of Spanish psychiatry (qua science) can be divided into four historical periods. (1) The native origins (up to the end of the eighteenth century). (2) The introduction of European psypchiatry (nineteenth century). (3) The period of consolidation (first third of the twentieth century). (4) From the Civil War (1936-39) to the present. These four periods provide a framework within which theories about delusion can be explored. Aspects of these four stages have been dealt with in earlier papers.

Delusions↗

[Archivos de Neurobiología: seventy five years of Spanish psychiatry].

One might consider that the first Spanish psychiatrists were a group of alienists, that have been forgotten for many years, who worked in isolated conditions in the asylums of the 19th Century. On the other hand, there were a group of personalities, university professors specialised in other disciplines, that were not psychiatrists but had a much greater influence than the former during the early stages of the development of Spanish psychiatry as a differentiated medical speciality. This development was produced (considerably later than in other European countries) in two successive stages: a preliminary one, with local or aborted institutions (from the 15th Century to the year 1919) and a further one, with institutions that extended throughout the entire country, and were developed between 1920 and 1936. These national institutions were the ones that defined the beginning of Spanish psychiatry. The first one, that appeared in January of 1920, was the journal Archivos de Neurobiología, that related each other, stimulated and served as on organ of expression to the remaining institutions that established this specialty. Finally, a summary is offered of the characteristics and the historical evolution of this journal emblematic of Spanish psychiatry, that is currently commemorating its 75th anniversary.

History, 20th Century↗

[Analytic preoperative control and serum alaninaminotransferase (ALT) activity].

A standard model of analytical preoperative profile does not exist, so we decided to perform a wide profile. In this revision, we studied the utility of determining serum ALT activity in analytical preoperative controls, searching for the causes of its elevation in pediatric patients who would undergo minor surgery. Of the 3,750 patients analysed, 1.57% showed elevated serum ALT activity. Searching for the main cause, we found the following groups: I) patients with diseases unrelated to the surgical procedures that cause elevated serum activity; II) patients on pharmacological treatments which may produce transitory elevations of serum ALT activity, and III) patients with elevated serum ALT activity that has no evident clinical or pharmacological cause. The high incidence of patients with this abnormality justified the inclusion of serum ALT activity in the profile. We conclude that: a) the reasons for this elevation should be investigated, b) pediatricians should consider postponing surgery, and c) resumption of normal serum ALT activity should be monitored.

Adolescent↗

[Neurofibroma of the lower lip].

Reporting a nervous tumor diagnosed as Neurofibroma, which owing to its localisation, on the lower lip, and its possible origin, from a salivary gland, should be considered an extraordinary rarity. The AA, make a bibliographic review of the commonest sites of the growth, the histological description and consider some possible differential diagnosis with special emphasis to the schwannoma and the Recklinghausen's disease.

Animals↗

A quantitative approach to the classification of hypospermatogenesis in testicular biopsies for infertility.

Absolute counts of germ cells were performed in 110 testicular biopsy specimens from 59 patients with either idiopathic infertility or varicocele and in a series of five autopsy specimens from age-matched controls. The tubular diameter, thickness of the tubular wall, and density of Leydig cells were measured. The following patterns were identified by germ-cell counts in the biopsy specimens: normal cell population, mild decrease in germ cells with normal ratio of cell types, advanced hypospermatogenesis with abnormal ratio of cell types, and Sertoli cell only. This sequence of progressive hypospermatogenesis was remarkably similar in both series. A separate category of maturation arrest was not recognized. Cell counts also correlated between right- and left-sided samples from the same patient in both series of biopsies. Reduction of tubular diameter, thickening of the tubular wall, and increase in Leydig cell density were often seen in severe stages of germ-cell impairment, although with an irregular distribution.

Adult↗

[Shwachman's syndrome: pancreatic exocrine insufficiency retarded growth, metaphyseal dysostosis and neutropenia (author's transl)].

A boy of 5 8/12 years of age affected with Shwachman's Syndrome is presented. He showed frequent respiratory infections that can be in order with a low account in T-lymphocytes found on immunological study. A cytoplasmic degenerative process was found after microscopical and ultrastructural vision of osteoid tissue, which is compatible with biochemical alterations.

Biopsy↗

The vasectomized testis.

We have performed a qualitative study on effects of vasectomy on the testicular structure. Vasectomy performed with the traditional technique changes testicular structure. At first, the injuries are slight and restricted, but gradually, and in a time-dependent manner, become more severe and extensive. Ultrastructure studies indicate that the spermatogonia and Sertoli's cells are the most resistant to vasectomy, and are even observed in some regenerating testes lacking a complete germinal epithelium. Morphometric studies revealed a decrease in epithelial depth, an increase in the thickness of the basement membrane and in surface of the interstitial space, all significant (P < 0.01) with respect to the control. However, the percentage of the interstitial tissue occupied by cells, did not show any significant difference. We propose that the increase of intraluminal pressure is the essential factor that provokes testicular atrophy.

Animals↗

[The concept of delirium in Spanish psychiatry (19th-20th century)].

The history of psychiatric knowledge in Spain can be divided into four differentiated periods (up to the eighteenth century; nineteenth century; first third of the twentieth century and the two final thirds). These four periods provide a framework within which theories about delusion can be explored. Spanish psychiatrists have not been very original. Nonetheless, some of them (Sanchís Banús, López Ibor, Martín Santos, Llopis, Valenciano, Sarró or Castilla del Pino) have tried to make personal contributions to the subject of delusion that deserve attention. Their theories (and some others) are reviewed in this paper.

Delusions↗