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Biomedical subjects

J Pulido

Publications and source records attributed to J Pulido.

16 recordsLinked to original sources
PubMed2000

Iris varix simulating an iris melanoma.

Iris varix is rare and little is known about its clinical characteristics. We treated a thrombosed iris varix that simulated an iris melanoma. A 53-year-old man developed a dark brown iris mass and hyphema in his left eye. Ultrasound biomicroscopy revealed a circumscribed mass of the iris stroma. Because of suspicion for melanoma, it was removed by sector iridectomy. Histopathologic examination disclosed an extensive focus of stromal hemorrhage, partially surrounded by endothelial cells that showed immunoreactivity to vascular markers. The histopathologic diagnosis was thrombosed iris varix. Iris varix is a rare condition that should be included in the differential diagnosis of iris melanoma.

Diagnosis, Differential↗
PubMed1999

Prestige of training programs and experience of bypass surgeons as factors in adjusted patient mortality rates.

OBJECTIVES: The relation of physician performance to physician training and experience is not well understood. The aim of this study was to examine whether indicators of physician background and experience were associated with an objective measure of physician performance. METHODS: Physician background information obtained from the Directory of Board-Certified Medical Specialists was linked to physician risk-adjusted mortality rates obtained from three statewide data bases of coronary artery bypass surgeons. Subjects were 275 surgeons who performed CABG surgery on 83,547 patients during the years 1989 to 1992. Surgical performance was measured by the mortality ratio (MR), the ratio of the observed to the predicted patient mortality rate as determined by detailed clinical information. Training institutions and physicians were characterized as prestigious if they were listed as outstanding in published articles. RESULTS: Surgical performance was not associated with graduation from an American medical school; attendance at a prestigious medical school, residency, or fellowship program; or an academic appointment. Mortality ratios decreased with increased volume and increased with years of experience, age, and academic rank. Surgeons were more likely to be considered a "best doctor" if they had more years experience and trained at a prestigious residency or fellowship program. CONCLUSIONS: Training at a prestigious institution was associated with identification as a "best" doctor but not with lower mortality ratios.

Adult↗
PubMed1999

Supportive periodontal therapy in South America. A retrospective multi-practice study on compliance.

BACKGROUND: Supportive periodontal therapy is needed for the success of periodontal therapy but there is little information about the extent of patient cooperation. It is known, however, that cooperation is poor and a matter of concern. METHODS: The present study is part of a more extensive study including information from 5,041 patient records from private periodontal practices in Brazil, Venezuela, Chile, and Argentina. Patient cooperation was measured according to gender, age, type of therapy (surgical or non-surgical), maintenance period (first year, 5 years, 10 years, 15 years, and 20 years), and level of cooperation (non-compliant, regular or irregular) for each of the 4 practices. RESULTS: We observed a great variation in the behavior of the patients from different practices, suggesting that studies on compliance cannot be generalized because differences in culture, economic conditions, knowledge of oral hygiene, and even the philosophy of treatment should be considered. The most significant data were sometimes similar for 2 or 3 of the countries but never for all 4 practices. CONCLUSIONS: Compliance is a very complex matter and findings from individual studies cannot be generalized.

Adult↗
PubMed1988

Intravenous and intraocular ganciclovir for CMV retinitis in patients with AIDS or chemotherapeutic immunosuppression.

The efficacy and toxicity of ganciclovir given by intravenous or intravenous plus intravitreal injection were studied in nine patients with cytomegalovirus (CMV) retinitis; seven with AIDS and two with drug induced immunodeficiency. Five patients had retinitis with macular involvement in six sighted eyes; six patients had only peripheral retinitis in seven eyes. In two patients (two eyes) with macular involvement intravenous plus intravitreal injection of ganciclovir preserved sight; intravenous infusion alone did not in four eyes of three other patients. In seven eyes (six patients) with peripheral retinitis vision was retained regardless of the route of ganciclovir treatment. Following intravenous ganciclovir drug levels in the vitreous fluid were 1.4-2.2 mmol/l, that is, 44 and 65% of the concomitant serum concentration. Clinically and at necropsy three eyes showed no evidence of toxicity from intravitreal injection of ganciclovir. All of five patients with AIDS who received intravenous ganciclovir for more than one week developed leucopenia. CMV retinitis of the macula may be benefited with minimal drug toxicity by intravitreal injection of ganciclovir. Treatment of peripheral CMV retinitis in patients with AIDS may be optional.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Intraocular 9-([2-hydroxy-1-(hydroxymethyl) ethoxy] methyl) guanine levels after intravitreal and subconjunctival administration.

Clearance studies in rabbits following intravitreal injection of 400 micrograms of 9-([2-Hydroxy-1-(hydroxymethyl)ethoxy]methyl) guanine demonstrated levels of the antiviral at 60 hours above the in vitro ID50 for several strains of human cytomegalovirus. Intravitreal administration of this new antiviral may have therapeutic application in the treatment of acute retinal necrosis and cytomegalovirus retinitis complicating acquired immune deficiency syndrome (AIDS).

Acyclovir↗
PubMed1986

Prostaglandin release following Nd:YAG iridotomy in rabbits.

In this study, iridotomies were performed in nine rabbit eyes using an Nd:YAG laser at 5.2 mJ, three pulses/burst, for one burst. Prostaglandin E2 (PGE2) in aqueous humor obtained at timed intervals after treatment was then measured using a sensitive and specific radioimmunoassay. Concentrations of PGE2 (mean +/- SD pg/ml) were: pretreatment, 377 +/- 89; 30 minutes, 1858 +/- 241; 120 minutes, 735 +/- 308; and 240 minutes, 401 +/- 59, postoperatively. The release of PGE2 into the aqueous humor parallels the rise in intraocular pressure following Nd:YAG iridotomies in rabbits and thus may contribute to this phenomenon.

Animals↗
PubMed1985

Intravitreal toxicity of hydroxyacyclovir (BW-B759U), a new antiviral agent.

We investigated the toxicity of the antiviral compound hydroxyacyclovir (9-[hydroxy-1-(hydroxymethyl)ethoxymethyl]guanine, or BW-B759U), following intravitreal injection in the rabbit. Intravitreal doses of 10, 20, 40, 80, 100, 200, and 400 micrograms produced no discernible ophthalmoscopic or histologic changes. Intravitreal doses of 40, 200, and 400 micrograms produced no changes in the electroretinography B-waves. The low level of retinal toxicity and excellent median inhibitory dose values of intravitreal BW-B759U against cytomegalovirus suggest its potential therapeutic utility in the treatment of cytomegalovirus retinitis.

Acyclovir↗
PubMed1984

Vitrectomy and intravitreal antiviral drug therapy in acute retinal necrosis syndrome. Report of two cases.

Two patients with acute retinal necrosis were treated with vitrectomy, intravitreal infusion of acyclovir, and prophylactic scleral buckling procedures. Both patients have had a uneventful postoperative course and a recovery of visual acuity; follow-up has been at five and 14 months. There has been no sign of toxicity from the intravitreally administered acyclovir by electroretinographic or clinical criteria.

Acute Disease↗
PubMedDate not supplied

Acute retinal necrosis.

Five patients with the acute stages of acute retinal necrosis underwent vitrectomy, with acyclovir in the infusion fluid, and the placement of a 360 degrees scleral buckle after intravenous therapy with acyclovir. Anatomic reattachment was achieved in all patients, and improvement over preoperative visual acuity was obtained in four. Recommendations for the treatment of acute retinal necrosis include a high index of suspicion in healthy patients with retinitis, early diagnosis, early intravenous therapy with acyclovir, early pars plana vitrectomy with the use of intravitreal acyclovir in the infusion fluid, and a 360 degrees scleral buckling procedure.

Acute Disease↗