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Biomedical subjects

J M Calvo-Romero

Publications and source records attributed to J M Calvo-Romero.

14 recordsLinked to original sources

Giant cell arteritis.

Giant cell arteritis (GCA), temporal arteritis or Horton's arteritis, is a systemic vasculitis which involves large and medium sized vessels, especially the extracranial branches of the carotid arteries, in persons usually older than 50 years. Permanent visual loss, ischaemic strokes, and thoracic and abdominal aortic aneurysms are feared complications of GCA. The treatment consists of high dose steroids. Mortality, with a correct treatment, in patients with GCA seems to be similar that of controls.

Aortic Aneurysm↗

Ischemic heart disease associated with vincristine and doxorubicin chemotherapy.

OBJECTIVE: To report the ocurrence of ischemic heart disease (IHD) in a patient with multiple myeloma treated with vincristine and doxorubicin. CASE SUMMARY: A 46-year-old man developed a Q-wave inferior and right-ventricle myocardial infarction with postinfarction angina after receiving his third cycle of vincristine and doxorubicin for immunoglobulin A multiple myeloma. Angiography showed two small filling defects consistent with thrombi in the distal right coronary artery. DISCUSSION: IHD may be a serious but uncommon complication of treatment with several chemotherapeutic agents. It is likely that chemotherapy played a role in the development of IHD in our patient. Several putative mechanisms for vascular toxicity have been associated with chemotherapy. CONCLUSIONS: Chemotherapy with vincristine and doxorubicin may play a role in the ocurrence of IHD. Physicians should possess an awareness of this potentially serious complication of chemotherapy.

Aged↗

Severe pancytopenia associated with low-dose methotrexate therapy for rheumatoid arthritis.

OBJECTIVE: To report the occurrence of severe pancytopenia associated with low-dose methotrexate (MTX) therapy for rheumatoid arthritis. CASE SUMMARY: Two patients developed severe pancytopenia after 10 days (cumulative dose 15 mg) and 23 months (cumulative dose 1030 mg), respectively, of low-dose MTX therapy for rheumatoid arthritis. Both patients had renal impairment. One died and the other recovered completely. DISCUSSION: Pancytopenia is a rare adverse effect of low-dose oral MTX therapy. The exact mechanism for development of pancytopenia is unknown, although it is likely that several factors play a role. The most important risk factor for MTX toxicity is impaired renal function. This adverse effect may occur at any time during MTX therapy. CONCLUSIONS: Severe pancytopenia associated with low-dose MTX therapy for rheumatoid arthritis is a potentially serious complication that may occur at any time during therapy. This adverse effect is more likely to occur in patients with renal impairment.

Administration, Oral↗

Recurrence of adrenal aldosterone-producing adenoma.

Conn's syndrome (adrenal aldosterone-producing adenoma) and bilateral adrenal hyperplasia are the most common causes of primary aldosteronism. The treatment of choice for patients with aldosterone-producing adenoma is unilateral total adrenalectomy. Recurrence after adequate surgery is exceptional. We present a patient with recurrence of an aldosterone-producing adenoma in the right adrenal gland 9 years after adenomectomy of a aldosterone-producing adenoma in the same adrenal gland. We conclude that adenomectomy is not an adequate therapy for patients with adrenal aldosterone-producing adenoma.

Adrenal Cortex Neoplasms↗

[Symptomatic sinus bradycardia associated with donepezil].

INTRODUCTION: Donepezil is a drug which is being used more and more widely in mild-moderate Alzheimer's disease. In general, it is well tolerated and the side-effects are basically cholinergic-dependent. Symptomatic disorders of cardiac rhythm associated with the use of donepezil are extremely unusual. CLINICAL CASE: We describe the case of an 81 year old patient with hypertensive cardiopathy, who developed sinus bradycardia, fainting and left cardiac failure three weeks after starting treatment with donepezil. When donepezil was stopped the sinus bradycardia disappeared, a 24 hour electrocardiographic holter showed no signs of sinus node disease and no episodes of this type occurred during the following six months. CONCLUSION: Symptomatic sinus bradycardia is a possible adverse effect of treatment with donepezil in Alzheimer's disease.

Aged↗

[Electrocardiographic abnormalities in subarachnoid hemorrhage].

INTRODUCTION: It has been described a great variety of electrocardiographic abnormalities in the acute phase of the subarachnoid hemorrhage (SAH), which are more frequent in patients with severe neurologic impairment and when there is myocardial damage. The presence of electrocardiographic tracings compatible with acute myocardial infarction (AMI) in the acute phase of the SAH is rare. CLINICAL CASE: We present a 77-year-old patient with an extensive SAH and an electrocardiographic pattern suggesting anterior transmural AMI, with a fatal outcome in a few hours. CONCLUSIONS: It should pay more attention to the possibility of cardiac complications in the SAH. Myocardial ischemia and SAH may coexist. The presence of electrocardiographic abnormalities in the acute phase of the SAH is not always indicative of cardiac pathology.

Aged↗