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Biomedical subjects

J M Cortés

Publications and source records attributed to J M Cortés.

15 recordsLinked to original sources

[Laryngeal chondro-radionecrosis].

Laryngeal chondroradionecrosis is a complication following radiotherapy for laryngeal tumours that may appear many years after the treatment. We present the case of a 78 year old man, that come to the Accident and Emergency department with a prelaryngeal mass and hemoptysis. He had been treated 17 years before with radiotherapy for a vocal cond carcinoma. Posteriorly the lesion did a cutaneous fistula with complete laryngeal exposition and torpid evolution. Post-radiotherapy necrosis in the larynx is a serious complication though not a common one. A tumour recurrence needs to be excluded and even in this case a total laryngectomy is mandatory as it will end in total loss of laryngeal function.

Aged↗

[Epidemic outbreaks of salmonellosis caused by eating eggs].

BACKGROUND: Investigation of outbreaks of foodborne infections (OFI) by Salmonella associated with the consumption of hens' eggs from a same classification center of Castellón, and determination of origin, extension and to take measures of control and prevention. METHODS: Descriptive and case-control studies, microbiologic analysis of feces, suspicious foods, and eggs. Sampling of eggs in the classification center for estimation the prevalence of Salmonlla. RESULTS: In 1992, 5 OFI were detected, 4 collective (1 school, 2 restaurants, and 1 residence) and 1 at home, by the consumption of food prepared with eggs: fried or boiled eggs, omelette, soufflé, 2 times, and home-made russian salad. Five hundred and forty-five persons were exposed and 364 were studied, with 100 case patients and 16 hospitalized. The range of attack rates was 10.5-87.0%. Samonella enteritidis (3 OFI) and S. typhimurium (3 OFI) were the infectious agents. In February 1993, the prevalence of Salmonella in eggs from the center was 0.26% (4/1.524) (S. enteritidis, 2 isolates, and S. typhimurium, 2 isolate), three on the shell, and one in the yolk. Two farmhouses of the six supplied were infected. CONCLUSIONS: These outbreaks indicate that salmonellosis by egg's consumption are frequent here and investigation of infection sources is necessary.

Adolescent↗

Porphyria cutanea tarda and hepatocellular carcinoma. Frequency of occurrence and related factors.

In order to assess the incidence of hepatocellular carcinoma (HCC) in porphyria cutanea tarda (PCT), 83 patients (77 males, 6 females, mean age 57.4 years) were studied. Thirteen patients (15.7%) had HCC, all of whom were male and cirrhotics with a mean age of 58.5 years. HCC patients showed a statistically significant (P less than 0.0005) longer evolution time (23 years since onset of the cutaneous disease) than patients without HCC (9.4 years), while the age of onset was similar in both groups. Differences in alcohol intake and hepatitis B virus (HBV) markers were non-significant, although high prevalence (54%) of past HBV infection was found in both groups. In HCC development, attributable risks of 100% were found for cirrhosis (P less than 0.001), male sex (P = NS) and for age over 51 (P less than 0.025). Therefore, PCT harbours a high incidence of HCC; evolution time, cirrhosis and age over 51 appear to be the most important contributing factors.

Adult↗

Lymphangioma of the duodenum.

A case of lymphangioma of the duodenum is reported, and the literature pertinent to its pathology reviewed. This is the eleventh case reported, and the third in which the diagnosis has been made by endoscopy. The clinical and histological characteristics are important, on account of its presentation and its penetrating character into the neighbouring structures. The characteristics of this tumor seen during endoscopy are discussed.

Duodenal Neoplasms↗

The pathology of the liver in porphyria cutanea tarda.

We report the findings in 53 biopsies from 45 patients with porphyria cutanea tarda (PCT). Red autofluorescence and birefringent acicular cytoplasmic inclusions were constant findings in all untreated cases. Autofluorescence occurs in other hepatic porphyrias, but acicular inclusions appear to be specific for PCT; we have seen them in subclinical porphyria and before development of cutaneous symptoms. They are probably uroporphyrins and they trend to disappear during rinsing by water during most staining procedures. We recommend unstained paraffin sections for their demonstration. Liver damage in PCT has features distinct from other liver diseases, including alcoholic liver disease. These include constant but mild periportal siderosis, focal lipofuscin deposition, focal lobular hepatocyte necrosis associated with groups of pigment-laden macrophages, focal steatosis, marked hepatocyte hyperplasia and the presence of periductal lymphocyte aggregates. The latter have not been previously described in PCT and were present in 43% of our cases. There is a direct relationship between increasing age and progressive distortion of liver architecture, with fibrosis present at a mean age of 48 years, cirrhosis at 57 and hepatocellular carcinoma at 66. The characteristic liver histology and the natural history of PCT are against this being the result of any non-specific liver damage and favour instead a specific liver disease whose pathogenesis may be mainly the result of the metabolic defect of PCT.

Adult↗

[Diagnosis of neonatal femoral thrombosis following umbilical arterial catheterization by ultrasonic flow detection].

At her second day of life, a 2,200 g, 34 weeks gestational age female newborn infant with idiopathic respiratory distress syndrome, under treatment with mechanical ventilation and monitored through an umbilical arterial catheter (UAC), had severe clinical signs of arterial obstruction of her left limb. Signs of occlusion at the common femoral artery level were evident at Doppler ultrasonography. Doppler determinations showed early arterial blood flow improvement before amelioration of skin coloration and arterial pulses, that allowed close observation and withholding of surgical treatment which was finally not necessary. Eighteen newborn babies with an umbilical arterial catheter were then prospectively followed by Doppler ultrasound flow determinations. No further cases with clinical signs of arterial occlusion were found and Doppler studies performed in these late cases showed normal results in all of them. Doppler ultrasound flow determination is helpful for the diagnosis and management of lower limb arterial obstruction in newborn infants with umbilical arterial catheters.

Catheterization, Peripheral↗

[Electrocardiographic changes in 29 apparently healthy subjects with positive serological tests for Chagas disease].

Of 78 apparently healthy subjects with positive serological tests for Chagas disease, 29 had EKG abnormalities. On direct questioning only two referred dyspnea, one had palpitations and another one dizziness. The most frequent EKG abnormalities were: peaked T waves in 10 cases; ventricular premature beats in 8 patients, right bundle branch block in 7, left bundle branch block in 5, abnormal ST-T segment in 4, atrial fibrillation in 3 cases, left ventricular hypertrophy in 3, and left anterior hemiblock in 3. As has been previously recognized, the EKG changes plus the positive serological tests are the earliest manifestations of Chagas disease.

Adolescent↗