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Biomedical subjects

J Suarez

Publications and source records attributed to J Suarez.

At least 37 records · Page 2Linked to original sources
PubMed1991

Colposcopic evaluation of human immunodeficiency virus-seropositive women.

To determine the effect of human immunodeficiency virus (HIV) infection on cervical histology, 32 known HIV-seropositive women underwent cervical colposcopic evaluation. All had cervical cytology, colposcopically directed biopsy, and T-cell studies performed. Thirteen of 32 patients (41%) had cervical intraepithelial neoplasia (CIN). Another 14 of 32 patients (44%) had histologic evidence of cervicitis. Abnormal cytology, noted in only three women, suggested CIN in one and inflammatory atypia in two. All (five of five) patients with a clinical diagnosis of AIDS had CIN, compared with 30% (eight of 27) of non-AIDS HIV-positive patients (P less than .05). Patients diagnosed with CIN had significantly lower CD4 cell counts (221/mm3 versus 408/mm3; P less than .06) and CD4:CD8 ratios (0.33 versus 0.62; P less than .02) than those without CIN. Patients with cervicitis had greater T-cell immunosuppression than did those with normal histology. In addition, patients with AIDS were more likely to have higher-grade lesions than were non-AIDS HIV-seropositive patients. Seven of 12 CIN specimens available for analysis by polymerase chain reaction using consensus sequence primers detected human papillomavirus (HPV) DNA, including three patients with three or more HPV types. Our data suggest that abnormal cervical pathology is common among HIV-positive women and that cytologic screening is not predictive of CIN in this population. In addition, the presence and severity of cervical dysplasia correlates with quantitative T-cell function. We strongly recommend that cervical colposcopy be part of the routine management of HIV-seropositive women.

Adult↗
PubMed1990

Functional significance of myocardial perfusion defects induced by dipyridamole using thallium-201 single-photon emission computed tomography and two-dimensional echocardiography.

The mechanisms responsible for inhomogeneous myocardial blood flow after oral administration of a large dose (300 mg) of dipyridamole were assessed in 27 patients with serial thallium-201 single-photon emission computed tomography (SPECT) and simultaneous 2-dimensional echocardiograms. Myocardial tomographic images were obtained 50 minutes and 3 to 4 hours after administration of dipyridamole. Two-dimensional echocardiograms were recorded at baseline and then every 15 minutes for 60 minutes. Dipyridamole caused only a mild reduction in blood pressure (from 129 +/- 18 to 126 +/- 16 mm Hg) and a mild increase in heart rate (from 69 +/- 15 to 73 +/- 4 beats/min). Sixteen patients had perfusion defects after dipyridamole by SPECT, which underwent partial or total filling-in. Fourteen of these patients (87.5%) had either a new abnormality or further deterioration of a preexisting wall motion abnormality by 2-dimensional echocardiography, and thus were considered to have developed transient ischemia during dipyridamole administration. Ten of 11 patients (91%) with normal perfusion or fixed defects by SPECT had no further deterioration in wall motion after oral dipyridamole, and were thus considered to have no evidence of myocardial ischemia. In conclusion, most patients with transient thallium-201 defects after dipyridamole develop transient worsening of resting wall motion by 2-dimensional echocardiography, suggestive of true myocardial ischemia. Because myocardial oxygen demand, as indicated by the heart rate-blood pressure product, did not change significantly, the mechanism of myocardial ischemia in these patients is likely to be diminished regional blood flow related to a "subendocardial steal" induced by dipyridamole.

Angina Pectoris↗
PubMed1988

Detection and prevention of deep venous thrombosis.

Deep venous thrombosis (DVT) is a significant problem in the postoperative course of high-risk patients. Risk factors that further predispose patients to DVT include obesity, age over 40 years, smoking, dehydration, and a prior history of thromboembolism. Diagnosis of DVT by physical examination and medical history is difficult; objective diagnostic techniques are often required. Considerable emphasis has been placed on the cost-effectiveness of implementing prophylactic measures in patients who are at high risk for developing DVT. Physical maneuvers attempt to reduce stasis and enhance venous return and pharmacologic approaches alter blood coagulability. The drug therapy used in preventing DVT consists of dextran, low-dose heparin, a combination of low-dose heparin and dihydroergotamine, and warfarin. Effective prophylactic regimens differ according to the type of patients at risk. Prophylactic therapy should be tailored according to the patient's disease and degree of risk.

Humans↗
PubMed1988

Variation in T helper cell/T cytotoxic-suppressor cell index during cardiac operations.

After surgical procedures, humoral and cell-mediated immunity responses decrease. Both anesthesia and surgical trauma play an important role in this effect. Cardiac operations induce a greater decrease in immunologic response than other surgical operations. On the other hand, identification of functional lymphocyte subclasses by means of appropriate monoclonal antibodies appears to provide an accurate measurement of cellular immune competence. Employing these methods, we found a significant decrease of T helper cell/T cytotoxic-suppressor cell ratio in the periperal blood of 20 patients undergoing cardiac operations. This decrease during the period of anesthesia (before surgical incision) is due as much to a decrease of T helper cell percentage as to an increase of T cytotoxic cell percentage. However, during the surgical trauma period (surgical incision to the end of the operation) it is due to a greater increase of T cytotoxic-suppressor cell percentage without significant changes in the percentage of T helper cells.

Adult↗
PubMed1988

Management and prevention of bacterial diarrhea.

The etiology, pathogenesis, transmission and communicability, diagnosis, and management of infectious diarrhea are reviewed. Infectious diarrhea is common in both industrialized and unindustrialized areas of the world. Better understanding of the etiology and pathogenesis and identification of "new" enteric pathogens has resulted in the use of a variety of drugs to relieve symptoms or to effect a clinical cure. Both host and microbial virulence factors are key in the acquisition of diarrheal illness. Host factors such as extreme age, a dysfunctional gastrointestinal tract, or underlying immunodeficiency enhance the risk of illness after ingestion of a pathogen or its toxins. Microbial virulence factors (the pathogen's ability to invade or produce enterotoxins, neurotoxins, or cytotoxins) characterize the type of illness manifested and the symptom complex (e.g., acute watery diarrhea versus chronic dysentery). Supportive care is indicated in the majority of cases of infectious enteritis, and rehydration is considered the mainstay of therapy in any diarrheal illness accompanied by dehydration. Antimicrobial therapy is beneficial in the treatment of severe diarrhea caused by Shigella, Campylobacter spp., Vibrio cholerae, Escherichia coli, and Clostridium difficile. Infectious diarrhea is common but is often self-limited and of short duration. Therapy frequently consists of symptomatic relief and fluid replacement.

Diarrhea↗
PubMed1987

Enhanced left ventricular systolic performance at high altitude during Operation Everest II.

Serial rest and upright cycle exercise 2-dimensional echocardiographic studies were performed in 7 healthy young men during acclimatization to a simulated altitude of 29,000 feet (barometric pressure [PB] 240 torr) in a chamber for 40 days. In all subjects left ventricular (LV) end-diastolic, end-systolic and stroke volumes progressively decreased, with mean reductions of 21%, 40% and 14%, respectively, on ascent to 25,000 feet (PB 282 torr) at rest, and reductions of 23%, 43% and 14% during 60-W exercise. At PB 282 torr, mean arterial blood O2 partial pressures were 37 torr (rest) and 32 torr (exercise), with corresponding O2 saturations of 68% and 59%. All 3 indexes of LV systolic function examined--ejection fraction, ratio of peak systolic pressure to end-systolic volume and mean normalized systolic ejection rate at rest--were sustained in all subjects at high altitude despite reduced preload, pulmonary hypertension and severe hypoxemia. Increases in ejection fraction of 6% at rest and 10% during exercise developed at PB 282 torr and a higher mean normalized systolic ejection rate in association with elevated circulating catecholamines reflecting enhanced sympathetic activity. LV systolic function is not a limiting factor in compromising the exercise capacity of normal humans on ascent to high altitude, even to the peak of Mt. Everest.

Acclimatization↗
PubMed1985

Three synchronous multiorgan primary cancers. All stage I.

A patient who has three separate, synchronous, early (stage I) primary cancers of the right lung, right breast, and stomach and whose disease is simultaneously diagnosed and successfully treated sequentially within a single hospital admission is unique. While multiple primary malignant neoplasms are not uncommon, to our knowledge, there has been no report of triple stage I synchronous carcinomas in separate major organ systems. Age, immunodeficiency, somatotype, hereditary tendencies, hormonal and environmental factors, and previous therapy have been incriminated as etiologic factors. Accurate tissue diagnosis and tumor staging are mandatory. In patients with diagnosed cancer, pulmonary lesions should never be presumed metastatic. Individual tumors should be treated independently of other concomitant lesions, and each treatment approach should be curative in nature. Patients with proven multiple malignant neoplasms carry a higher risk of developing other primary neoplasms.

Aged↗
PubMed1985

Sex differences in the effect of extirpation of the submandibular salivary glands in rats.

Because of the known interaction between the endocrine system and the structure and function of submandibular glands, the effects 3 months after extirpation of these glands in male and female rats were studied including the following parameters: change of body weight, sexual maturity (in females), sexual behaviour (in males), blood sugar, total proteins, haematocrit, the weight of various glands and oxygen uptake of various cerebral and glandular structures. The response in the two sexes was in each case different.

Animals↗
PubMed1984

Chondrosarcoma of the uterus.

Chondrosarcoma of the uterus is a rare tumor. The clinical and pathological features of a recent case are presented and the histogenesis, treatment, and prognosis of the heterologous sarcomas are discussed. The authors favor the theory of totipotential endometrial stromal cells for the histogenesis, and suggest that radiotherapy and/or chemotherapy continue to be used in addition to total abdominal hysterectomy with bilateral salpingo-oophorectomy.

Chondrosarcoma↗
PubMed1981

[Coronary surgery combined with peripheral vascular surgery. Apropos of 10 cases].

Coronary artery surgery may be envisaged in the context of diffuse arterial disease, especially in association with lesions of the cerebral and lower limb axes. The object of this paper is to advance the concept of coronary surgery coupled with peripheral vascular surgery. Ten patients underwent double revascularisation (coronary and peripheral vessels) between 1977 and 1979. In Group I (5 patients) coronary surgery was coupled with simultaneous cerebral revascularisation (1 aorto-brachiocephalic bypass and 4 endarterectomies). Group II comprised 5 patients undergoing simultaneous coronary and aorto-bifemoral bypass surgery. No operative deaths or serious complications were observed in this short series. The practical conclusions are in favour of widening the indications for simultaneous coronary and cerebral revascularisation. However, the indications for coronary surgery coupled with lower limb revascularisation must be precise and, therefore, more limited.

Aged↗