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Biomedical subjects

J M Vicente

Publications and source records attributed to J M Vicente.

16 recordsLinked to original sources
PubMed2006

[Low-dose 0.25% spinal levobupivacaine with epidural extension for cesarean section: comparison with 0.5% hyperbaric bupivacaine].

INTRODUCTION: When low doses of local anesthetic are used in combined spinal-epidural anesthesia for cesarean section, an epidural catheter can be used to enhance a possibly incomplete block or insufficient dose. OBJECTIVE: To compare the efficacy of spinal 0.5% hyperbaric bupivacaine with fentanyl (20 microg) at a conventional high dose of 0.07 mg cm(-1) (group 1) vs 0.25% levobupivacaine at a low dose of 7.6 mg with fentanyl (20 microg) and epidural volume extension with 6 mL of saline through an epidural catheter (group 2). MATERIAL AND METHODS: A randomized clinical trial enrolling patients scheduled for elective cesarean section. RESULTS: Sixty-two patients were studied (31 in each group). Characteristics in the groups were comparable at baseline and the maximum level of sensory block achieved was sufficient for all but 1 patient in group 2 who required general anesthesia. The bupivacaine dose in group 1 ranged from 10.5 to 12 mg. The motor block and duration was less intense in group 2 (P<0.0001) and patients in that group could be transferred out of the postanesthetic care unit earlier. CONCLUSIONS: The use of low doses of levobupivacaine with an opiate in combination with volume extension through an epidural catheter in the context of combined spinal-epidural anesthesia is a safe, effective technique that may allow the doses and motor block to be reduced when hyperbaric levobupivacaine is administered, without adverse events for patients.

Adult↗
PubMed2004

Successful induction of immune tolerance with FIX recombinant in a patient with haemophilia B with inhibitor.

We describe successful induction of immune tolerance in a 12-month-old patient with severe haemophilia B and low-titre and low response antifactor IX inhibitor at 5 Bethesda Unit (BU). Immune tolerance induction (ITI) was started with recombinant factor (rFIX) at 40-50 U kg(-1) day(-1) (1000 U three times per week) and 2 years after the beginning of therapy the inhibitor had been reduced to undetectable values. As complications, which appeared during the ITI, the patient presented minor haemorrhagic complications, which remitted following the administration of rFVIIa, and recurring infections of the catheter, requiring the withdrawal and subsequent placement of a new catheter.

Child, Preschool↗
PubMed2003

Treatment of complete obstruction of the nasolacrimal system by temporary placement of nasolacrimal polyurethane stents: preliminary results.

AIM: To assess the efficacy of the temporary placement of polyurethane nasolacrimal stents as a treatment for complete post-saccal obstruction of the lacrimal apparatus. MATERIALS AND METHODS: Polyurethane nasolacrimal stents were inserted under radiological guidance in nine patients with grade IV epiphora due to complete obstruction of the lacrimal system, at the junction of the lacrimal sac and duct (eight patients) or in the lacrimal duct (one patient). On average, the stents were removed 4 months (range: 3-6 months) after insertion. Dacryocystography was performed immediately before and after each stent was removed. Subsequently, periodic clinical and radiological examinations were performed until recurrence of the epiphora, at which point follow-up concluded. RESULTS: All patients remained free of epiphora and clinical inflammation while the stents were in place, but re-obstruction of the lacrimal system occurred in all patients less than 2 months after the stents were removed. Adhesion of three stents to the lacrimal tract was observed upon removal. In seven cases the dacryocystography results at the end of follow-up revealed changes in the configuration of the lacrimal apparatus. CONCLUSION: Based on our preliminary experience, temporary placement of polyurethane stents would not appear to be an efficacious therapeutic option for treating epiphora caused by post-saccal obstruction.

Adult↗
PubMed2001

Comparative genomics of Listeria species.

Listeria monocytogenes is a food-borne pathogen with a high mortality rate that has also emerged as a paradigm for intracellular parasitism. We present and compare the genome sequences of L. monocytogenes (2,944,528 base pairs) and a nonpathogenic species, L. innocua (3,011,209 base pairs). We found a large number of predicted genes encoding surface and secreted proteins, transporters, and transcriptional regulators, consistent with the ability of both species to adapt to diverse environments. The presence of 270 L. monocytogenes and 149 L. innocua strain-specific genes (clustered in 100 and 63 islets, respectively) suggests that virulence in Listeria results from multiple gene acquisition and deletion events.

Adaptation, Physiological↗
PubMed2001

Squamous cell carcinoma of the oesophagus in a patient with Klippel-Trenaunay syndrome.

The Klippel-Trenaunay syndrome (KTS) is a rare disorder characterized by a triad of port-wine stains, varicose veins, and bony or soft tissue hypertrophy of one extremity. Digestive bleeding is the most commonly observed gastrointestinal manifestation. In rare cases, the syndrome is associated with malignancies. We report the case of a 38-year-old woman with KTS and dysphagia caused by an oesophageal squamous cell carcinoma.

Adult↗
PubMed1998

Gastrointestinal autonomic nerve tumors (plexosarcomas). is A radiological diagnosis possible?

The gastrointestinal autonomic nerve (GAN) tumor, or plexosarcoma, is a very uncommon stromal tumor of the gastrointestinal tract and retroperitoneum. Distinction of GAN tumors from other stromal tumors is not possible based on imaging studies, and needs specific ultrastructural and inmunohistochemical techniques. There are some morphologic characteristics that the radiologist should know, so as to include these rare tumors in the differential diagnosis of an abdominal mass. We report two new cases: small bowel (jejunum-ileum) and stomach GAN tumors.

Aged↗
PubMed1998

Transcatheter embolization of symptomatic hepatic venous malformations.

The aim of this study was to evaluate our results in treatment and management of symptomatic hepatic venous malformations using transcatheter embolization therapy. From 1991 to 1997 five venous malformations were embolized in one man and four women ranging in age from 31 to 50 years. All patients presented nonspecific abdominal pain and were assessed in the general surgery unit. Percutaneous embolization was recommended. In all cases polyvinyl alcohol was used to embolize the afferent arterioles. Clinical and echographic control follow-up was carried out on an outpatient basis in our Vascular and Interventional Radiology Unit. Embolization was possible in all cases. No complications developed during the procedure, except in one case where the subject suffered a spasm of the hepatic artery. Mean follow-up time was 42 months (6-73 months). Four patients remained asymptomatic during the entire follow-up period, whereas one patient required reembolization. In our experience, transcatheter embolization of hepatic venous malformations is a noninvasive technique which requires few admissions and presents few complications. With further use, it could become the treatment of choice in symptomatic hepatic venous malformations as an alternative to surgery.

Adult↗
PubMed1998

[Tularemia: report of 16 cases in the Castilla-Leon community].

OBJECTIVE: To report the clinico-epidemiological characteristics of 16 patients with the diagnosis of tularemia. METHOD: Retrospective review of clinical records of patients admitted to the hospital or examined at health centers in Vizcaya, with clinical course and epidemiology consistent with tularemia, from January to March 1998. CASE DEFINITION: Patient with suggestive clinical course and epidemiology (exposure to hares coming from the epizootic area) and positive serology (antibodies to Francisella tularensis > 1/160 in convalescent phase serum). RESULTS: Sixteen patients (8 males, 8 females) with a mean age of 53 years. The incubation period ranged from 1 and 8 days (mean: 5). Nine patients had the ulceroganglionar form, two the pharyngeal form, one the oculoganglionar form and one the typhoidal form. In three patients only cutaneous lesion or lesions were observed. The antibiotic treatment administered included streptomycin for five patients, tobramycin for 2 patients, and ciprofloxacin, azithromycin and amoxicillin (plus doxycycline) for other three patients. Three patients received initially antitermic drugs (with poor response) and later two of them, doxycycline. The administered antibiotic in the remaining three patients was unknown. The clinical course was satisfactory in all of them and so far no relapses have been detected. CONCLUSIONS: The ulceroglandular form, as it appears in literature, was the most common form in this series of patients with tularemia. Neither severe diseases nor complications were observed. Although streptomycin is considered the drug of choice, other antibiotics are likely equally effective, at least for the non complicated forms of the disease.

Adult↗
PubMed1997

Gastric emphysema in a child with congenital duodenal diaphragm.

The presence of gas in the wall of the stomach in a child is a rare condition and usually indicates necrotising enterocolitis. We report a case of gastric emphysema in a 20-day-old baby girl with duodenal obstruction due to a congenital duodenal diaphragm. This association is extremely rare and has been described only once in the literature.

Duodenal Obstruction↗
PubMedDate not supplied

Disseminated bacillus Calmette-Guerin infection in an HIV-infected child: a case with cutaneous lesions.

A boy born to a mother with unknown HIV infection was immunized with BCG in his first month of life. Seven months later axillary adenopathy developed. At the age of 10 months, 2 months after HIV infection had been diagnosed, papular skin lesions appeared all over his body. Mycobacterium bovis, BCG strain, was cultured from a lymph node and blood. Ziehl-Neelsen stain of a skin biopsy specimen showed histiocytes loaded with numerous acid-fast bacilli. The patient died 10 days later, before the infection was confirmed. This is the first reported case of disseminated BCG infection in an HIV-infected child presenting with cutaneous lesions.

Axilla↗