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J Noguera

Publications and source records attributed to J Noguera.

At least 19 recordsLinked to original sources

[Initial results of the National Registry of Laparoscopic Liver Surgery].

INTRODUCTION: Experience in laparoscopic liver surgery is limited, and multicenter studies with large series are required for a critical evaluation of this type of surgery. OBJECTIVE: To analyze the results of the National Registry of Laparoscopic Liver Surgery. Indications, technical features, conversion rates, morbidity, and mortality were analyzed. PATIENTS AND METHOD: Seventy-four patients from 10 centers who underwent surgery between February 2000 and April 2005 were included. There were 58 women and 16 men, with a mean age of 55 years. More than one lesion was present in 16 patients. Consequently, 74 patients with 156 lesions were treated. RESULTS: Forty-six patients had cystic lesions (26 simple cysts, 13 polycystic disease, five hydatid cysts and two cystic adenomas). Surgical treatment consisted of 37 fenestrations, five cystopericystectomies, two atypical resections, one segmentectomy and one bisegmentectomy of segments II-III. In 28 patients the lesions were solid (four adenomas, six focal nodular hyperplasias, three hemangiomas, four hepatocarcinomas, five colorectal metastases, two lung metastases, one breast metastasis, one malignant melanoma metastasis, one pancreatic vipoma metastasis, and one lymphoma). Ten bisegmentectomies of segments II-III, 17 atypical resections and one segmentectomy of segment III were performed. Other surgery was associated in 23 patients. The mean operating time was 160.5 minutes and the conversion rate was 8%. The mean length of hospital stay was 5.6 days and was less than 5 days in 78% of the patients. Analgesia was administered for less than 48 hours in 55%. Morbidity was observed in eight patients (10.8%). Reoperations were performed in three patients. There was no mortality in this series. CONCLUSIONS: Laparoscopic hepatic resection is safe and feasible in selected patients. Large, controlled series are required to determine long-term outcomes. The national registry provides a good basis for evaluating laparoscopic liver surgery in Spain.

Female↗

Biochemical analysis and immunohistochemical determination of cardiac troponin for the postmortem diagnosis of myocardial damage.

Cardiac disease is the most common cause of sudden death in Western nations. In forensic practice there is a need for more sensitive diagnostic methods for the postmortem diagnosis of myocardial damage. The aim of this study was to analyse the diagnostic efficacy of biochemical markers in cadaver fluids in conjunction with histological studies and the immunohistochemical determination of cardiac troponin C (cTnC) and cardiac troponin T (cTnT) levels in myocardial tissue fixed in formol and included in paraffin. We studied 50 cadavers (43 males and 7 females) with a mean age of 47.5 years (SD 19.2; range 12 to 87 years). Cases were chosen according to the postmortem interval, cause of death, and circumstances of death. Pericardial fluid and serum were tested in duplicate for cardiac troponin I (cTn I), myoglobin and CKMB by immunoassay system using commercial kits. In myocardial tissue, histological studies were performed with hematoxylin and eosin (HE), Masson's trichrome staining and immunohistochemical techniques involving streptavidin-biotin-peroxidase were performed. The results pointed to statistically significant differences for all the biochemical markers in pericardial fluid. The highest levels were obtained in the group of cadavers who had died from myocardial infarction. The immunohistochemical expression of cTnC was detected in 86% of cases; it was strongly positive and usually diffuse. The expression of cTnT, was much less frequent (46% of cases) and less intense. It was concluded that the immunohistochemical determination of cTnC and cTnT levels in myocardial tissue may be used as an index of myocardium damage.

Adolescent↗

Diagnostic efficacy of biochemical markers in diagnosis post-mortem of ischaemic heart disease.

In forensic medicine, there is a need for more sensitive biochemical markers for the post-mortem diagnosis of acute myocardial infarction. A study of the distribution of biochemical markers in different fluids is of great significance in post-mortem diagnosis, because their distribution depends on the location of tissue damage and release kinetics. The aim of this study is to compare the sensitivities and specificities of creatine kinase-MB (CK-MB), myoglobin and cTnI in serum and pericardial fluid for the post-mortem diagnosis of acute myocardial infarction (AMI). We studied 188 cadavers selected during 1 year from medicolegal autopsies. The groups were as follows: (1) myocardial infarction (n = 52); (2) asphyxia (n = 59); (3) multiple trauma (n = 41); (4) natural deaths excluding myocardial infarction (n = 36). We obtained statistically significant differences in pericardial fluid for all the biochemical markers, the highest levels being obtained in the group of cadavers who had died from myocardial infarction. A common factor is the high negative predictive value found in biochemical markers, which is contrary to the findings obtained in clinical practice, when the percentages of sensitivity are very high.

Adolescent↗

Cardiac troponin I (cTn I) and the postmortem diagnosis of myocardial infarction.

In clinical practice several biochemical markers are used for the diagnosis of myocardial infarction. Because of its extremely high specificity for myocardial damage, cardiac troponin I (cTn I) is frequently used. The aim of this study was to evaluate the diagnostic efficacy of postmortem cTn I determinations in pericardial fluid and serum and to compare these results with other biochemical markers and with structural findings used to diagnose acute myocardial ischaemia. We studied 89 cadavers with a mean age of 51.38 +/- 2.04 (SD 19.27 years). Cases were allocated to 1 of 4 diagnostic groups depending on the probable intensity of myocardial damage and cause of death. In pericardial fluid we obtained statistically significant differences for the four biochemical parameters, while in serum myosin heavy chains and myoglobin showed statistically significant differences. The highest levels of biochemical markers in pericardial fluid were observed in subjects who had died from definite myocardial infarction.

Asphyxia↗

Multi-centre double-blind trial on the efficacy and safety of sertaconazole 2% cream in comparison with miconazole 2% cream on patients suffering from cutaneous mycoses.

The efficacy and tolerance of 7-chloro-3-[1-(2,4-dichlorophenyl)-2- (1H-imidazol-1-yl)ethoxy-methyl]benzo[b]thiophene (sertaconazole, FI-7045, CAS 99592-32-2) 2% dermatological cream in two daily applications compared with miconazole 2% cream in two daily applications were studied on 631 patients suffering from superficial cutaneous mycosis (sertaconazole n = 317, miconazole n = 314), in a double-blind, controlled multicentre trial with parallel groups. The therapeutic efficacy was evaluated by clinical assessment of the improvement of the lesion and symptoms, a microscopic test on the presence of hyphae or mycelia in the affected area and a culture test on the presence of active infection. Tolerance and safety were evaluated by a general blood analysis and interrogation of the patient on adverse effects. The rate of clinical cures for both treatments at the end of the follow-up was 95.6% for sertaconazole and 88.1% for miconazole, with the difference being statistically significant. In the comparative analysis of the actuarial curve, it was observed that the patients treated with sertaconazole were cured earlier and in a higher proportion than those treated with miconazole, with the difference being significant. The negative result of the microscope examination and culture test confirmed the superiority of sertaconazole over miconazole, already after 14 days of treatment. At the end of the follow-up, 98.6% of the patients in the sertaconazole group obtained a negative culture test result, as opposed to 91.7% in the miconazole group, with the difference being highly significant.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Topical↗

Polymorphic eruption of pregnancy: histopathologic study.

The microscopic findings in 31 biopsies of patients with polymorphic eruption of pregnancy are reported with a literature review. Cutaneous changes include edema, dermal lympho-histiocytic infiltrate and epidermal lesions. We have found a correlation between the intensity of the inflammatory response and the presence of epidermal involvement. In our opinion, the histopathological changes may allow an accurate diagnosis with the adequate clinical information. Direct immunofluorescence did not reveal immunoglobulin or complement deposits in the ten cases studied. It may help in the differential diagnosis with nonbullous herpes gestationis.

Adolescent↗

Septal granulomatous panniculitis in Sweet's syndrome. Report of two cases.

Two patients had Sweet's syndrome (acute febrile neutrophilic dermatosis) with subcutaneous lesions resembling erythema nodosum. In both, the erythema nodosum--like lesions histologically showed a septal granulomatous panniculitis with numerous Miescher's granulomas. This type of subcutaneous involvement in Sweet's syndrome should be differentiated from panniculitis caused by deep subcutaneous neutrophilic infiltration. Involvement of the panniculus in Sweet's syndrome may then occur in two different patterns: a septal granulomatous panniculitis, as in our two cases, or a neutrophilic lobular panniculitis, as has been previously reported.

Adult↗

Ethylene oxide dermatitis.

A case of contact dermatitis produced on the face of patient after the application of an oxygen mask is described. This paper includes the results of epicutaneous tests, the identification of the possible etiological agent and chromatographic analysis of the samples sterilized by ethylene oxide.

Dermatitis, Contact↗

[Clinical evaluation of amiodarone hydrochloride as an anti-arrhythmia agent].

15 patients with ventricular and supraventricular arrhythmias treated with Amiodarone hydrochloride via oral were studied. The results obtained show that in 86'6% of the cases the arrhythmia disappeared immediately, in 6'6% the arrhythmia disappeared late and in only one case the arrhythmia persisted. Statistical significance was found in the reduction of cardiac frequency as well as in the corrected QT interval for the frequency. The latter is an indirect consequence of the mode of action of the drug. The only side effect observed was the appearance of corneal opacification. It was demonstrated that this side effect is negligible when low doses which are equally effective are administered. The conclusion that Amiodarone is an excellent oral antiarrhythmic drug is reached. A daily dose of 400 mg during the first 20 days of each month with a rest of 10 days is recommended. In this way, the corneal opacification is minimal or nil. The possibility that the association of the drug with Quinidine could be effective in maintaining sinus rhythm post D.C. is suggested.

Administration, Oral↗