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Biomedical subjects

J Vargas

Publications and source records attributed to J Vargas.

At least 127 records · Page 7Linked to original sources
PubMed1982

Prolonged constant rate elemental enteral nutrition in Crohn's disease.

Constant rate enteral nutrition (CREN) has been used in 17 pediatric patients with Crohn's disease. Exclusive CREN was maintained from 2 to 7 months and progressively reduced to assure fractioned oral intakes from 12 to 22 months. From this preliminary study, CREN appeared to be as effective as steroid therapy in initiating remission of active Crohn's disease and was able to suppress steroid dependence. In some cases with prolonged CREN, reduction or disappearance of stenotic lesions of the bowel was observed. Two other positive points must be emphasized: the favorable psychological impact of the method and the ability to avoid growth suppression secondary to steroids. The long-term effects and longer remissions must be confirmed by a multicenter study in a larger group of patients.

Adolescent↗
PubMed1982

[Value of digestive manometry in scleroderma of childhood].

The authors report a case of systemic scleroderma in a 7 year-old boy, with digestive, cardiac and cutaneous involvement. They stress for the first time the pediatric significance of esophageal and recto-anal manometry from an etiologic topographic point of view.

Child↗
PubMedDate not supplied

Anapsos, an antipsoriatic drug which increases the proportion of suppressor cells in human peripheral blood.

Anapsos, an antipsoriatic drug, was administered to normal volunteers in order to study its possible activity on the immune system. After three days of treatment, the drug decreased the lymphoblastic response to PWM and very slightly reduced the serum levels of immunoglobulins. After five days of treatment, however, both values were normal. The response to ConA decreased, and there was an increase in the suppressor index and in the proportion of OKT 8+. The drug did not vary the proportion of OKT 4+ and OKT 3+ cells. These results suggest that anapsos acts by increasing the number of suppressor cells. Such anapsos-induced suppressor cells are probably responsible for the diminished response to ConA, but did not seem to significantly affect response to PWM and serum levels of Ig after five days of treatment.

Adolescent↗
PubMedDate not supplied

Protracted hemorrhagic gastritis in an infant recovering from acute pancreatitis--successful management with prostaglandin E2 analogue.

This case report describes the course and management of a 10-week-old boy with idiopathic hemorrhagic pancreatitis who presented initially with ascites. His hospital course was complicated by severe recurrent intraperitoneal bleeding, requiring, in less than 5 days three exploratory laparotomies to control the hemorrhage. In the following 11 weeks he had five major bleeding episodes attributed to ulcers, gastritis, and esophagitis. Continuous infusion of H2 blockers, antacid drip, and sucralfate combined with Nissen fundoplication, elective vagotomy, and pyloroplasty were used unsuccessfully to control the bleeding until a prostaglandin E2 analogue at 18 micrograms/kg/day in four divided doses was given enterally. During the following 19 months, there has been no recurrence of bleeding.

Acute Disease↗
PubMedDate not supplied

Horseshoe kidney presenting as a retroperitoneal mass. Report of a case diagnosed by fine needle aspiration cytology.

BACKGROUND: Horseshoe kidney is a renal congenital anomaly. It is the result of the fusion of either upper or lower poles of both kidneys, appearing as a horseshoe-shaped structure. This anomaly is very frequent: it can be found in about 1 of every 50-1,000 autopsies). CASE: Computed tomography performed routinely after pancreatitis in a 37-year-old female showed a retroperitoneal mass of uncertain origin. Fine needle aspiration cytology (FNAC) smears evidenced normal renal tissue. Urography confirmed the diagnosis of horseshoe kidney. CONCLUSION: This is the first reported case of horseshoe kidney diagnosed by FNAC. It demonstrates the utility of FNAC for diagnosis of retroperitoneal masses, especially if they are asymptomatic.

Adult↗
PubMedDate not supplied

Intravenous fat emulsion (intralipid) delays gastric emptying, but does not cause gastroesophageal reflux in healthy volunteers.

The impact of overnight intravenous lipid emulsion (ILE) infusion on upper gastrointestinal tract physiology was assessed in 10 healthy volunteers. No changes in lower esophageal sphincter pressure (before infusion: 28 +/- 4 mm Hg; after infusion 20.5 +/- 3; p:NS), plasma concentrations of gastrointestinal hormones (gastrin: preprandial before/after lipids: 14 +/- 2.1/13 +/- 1.4 pM; postprandial before/after lipids: 28 +/- 2.7/30 +/- 3.4 pM, CCK: preprandial before/after lipids: 69 +/- 10/64 +/- 10 pM; postprandial before/after lipids: 96 +/- 11/95 +/- 12 pM; neurotensin: levels less than 6 pM in all samples; somatostatin levels undetectable in all samples) nor on pathologic gastroesophageal reflux episodes (% of time of pH less than 4, before/after lipids: 0.6 +/- 0.4/0.15 +/- 0.09), were found (p = NS). In contrast, technetium gastric emptying studies showed a significant delay when comparing pre- and post-lipid infusion values (37 +/- 4/54 +/- 4%) (p greater than 0.005). The mechanism of this effect remains unexplained.

Adult↗
PubMedDate not supplied

[Tumors of the posterior fossa in children].

INTRODUCTION: Primary tumours of the CNS form 20% of the neoplasias seen in children. They are the second commonest type of cancer seen in childhood, after leukemia. A significant proportion of paediatric cerebral tumours (> 50%) are intratentorial. OBJECTIVE: To find the frequency and clinicopathological behavior of posterior fossa tumours in children seen at our hospital. PATIENTS AND METHODS: From the hospital records, a descriptive, retrospective study was made of 112 children with tumours of the posterior fossa who were attended at the Institute of Neurology and Neurosurgery between January 1980 and December 1997. The variables: age, sex, clinical findings, site and extent of the tumour and its histological description were recorded. The mean, standard deviation, frequency distribution and chi-squared test were used, depending on the type of variable to be analyzed. RESULTS: The age of the patients when the diagnosis was made was between 8 months and 15 years (mean = 8.32 years). The male/female ratio was 59/53 (1.1/1). The commonest site of the tumours was the cerebellum (58.9%). The predominant histological types were medulloblastoma (33.92%) and astrocytoma (19.64%) in the cerebellum, glioma in the brain stem (10.71%) and ependymoma in the i.v. ventricle (8.09%). CONCLUSIONS: Endocranial hypertension and the cerebellar syndrome were the predominant clinical findings in medulloblastoma, cerebellar astrocytoma and ependymoma. In brainstem gliomas there was often involvement of several cranial nerves and long tracts.

Adolescent↗
PubMedDate not supplied

[Arrhythmogenic dysplasia of the right ventricle: a cause of ventricular tachycardia in childhood].

We describe a 9-year old patient with arrhythmogenic right ventricular dysplasia. The patient presented with sustained ventricular tachycardia in an apparently normal heart. The diagnosis was suspected by the electrocardiographic morphology of the tachycardia and definitive diagnosis was made by right ventricular angiogram, echocardiogram and the ventricular endomyocardial biopsy findings (replacement of myocardial by adipose tissue and fibrosis). We believe that this condition may be a common etiology of ventricular tachycardia with left bundle branch block conduction pattern in children with otherwise normal hearts.

Adipose Tissue↗
PubMedDate not supplied

Epithelial atypia in gynecomastia induced by chemotherapeutic drugs. A possible pitfall in fine needle aspiration biopsy.

The clinical, cytopathologic and histopathologic features of a case of gynecomastia induced by chemotherapeutic drugs are described. Fine needle aspiration (FNA) smears showed epithelial atypia, and an erroneous cytologic diagnosis of carcinoma was made. Histopathologic study showed gynecomastia with epitheliosis, papillomatosis and atypical ductal hyperplasia. Review of the FNA smears showed the findings to be more typical of a reparative or regenerative process; these findings had been cytologically overinterpreted, partly due to the lack of adequate clinical information submitted with the aspirate. The possible causes of gynecomastia, the induction of epithelial atypia by cytotoxic chemotherapy and the cytologic features whose recognition may prevent false-positive diagnoses in such cases are discussed.

Adult↗
PubMedDate not supplied

Endometriosis in an inguinal crural hernia. Diagnosis by fine needle aspiration biopsy.

The fine needle aspiration (FNA) biopsy findings of endometriosis is an inguinal crural hernia in a 40-year-old woman are presented. The cytologic findings were similar to those previously reported in aspirates of solid endometriosis in other sites: nonatypical, small, epithelial groups in an inflammatory and proteinaceous background. The cytologic diagnosis of a benign epithelial lesion, possibly endometriosis, was confirmed by histologic study of the extirpated mass. This case shows that endometriosis must be included in the differential diagnosis of FNA samples of palpable lesions of the groin in women of reproductive age.

Adult↗
PubMedDate not supplied

Severe cytomegalovirus infection and immunosuppressive therapy in pediatric liver transplantation.

Twenty-two post-orthotropic liver transplant (OLT) recipients were studied to investigate the clinical, laboratory and histopathological differences between rejection and CMV infection. The mean age at the time of transplantation was five years. Nine of 22 (41%) patients developed positive CMV, CF-IgG and IgM antibody titers and cultures for CMV following surgery, and three (group 1a) developed interstitial pneumonitis. CMV specific inclusion bodies were found in lung and liver biopsies. Two patients in group 1a were treated successfully with DHPG and decreasing immunosuppressive treatment, while the third died. Clinical presentation of rejection episodes were similar in all groups. CMV infected patients (group 1) received more transfusions of blood and blood products than the non-infected patients (group 2). Rejection episodes occurred sooner and more frequently in group 1a than in group 1b (CMV infected-asymptomatic) and group 2 (non-infected). Group 2 received fewer steroid boluses as well as azathioprine and OKT 3. A percutaneous liver biopsy with routine stains helped detect CMV when inclusion bodies were seen. We conclude that culture proven CMV infection is common post-OLT. Severe CMV infection occurred more frequently in those who had received greater doses of immunosuppressive therapy for possible graft rejection. Monitoring CMV infection following OLT is absolutely necessary. After OLT, decreasing the immunosuppressives and using antiviral agents are important in the management of CMV infection.

Adolescent↗
PubMedDate not supplied

[Surgical alternatives in the treatment of double-outlet right ventricle].

Double-outlet right ventricle (DORV) is a type of ventriculo-arterial connection, in which both great arteries are connected to the morphologically right ventricle in at least 50% of their diameter. The relation of the great arteries with the ventricular septal defect (VSD) and the pulmonary stenosis, are important anatomical aspects in the election of the surgical technique. In this study we describe four patients with DORV, in whom different surgical techniques were used according to the specific anatomy of each case. Two patients had subaortic restrictive VSD, with subpulmonary stenosis in one of them. In the other two patients the VSD was subpulmonary with the aorta anterior and to the left, in one of these existed moreover a severe mixed pulmonary stenosis. It is concluded, that with different surgical techniques according to the specific anatomy of each patient, good results can be obtained in the surgical treatment of these complex congenital malformations.

Child↗
PubMedDate not supplied

Fine needle aspiration cytologic findings and differential diagnosis of solitary pseudorheumatoid nodule.

The cytologic findings in fine needle aspirates of two solitary pseudorheumatoid nodules are presented. The main characteristic of the smears was a necrotic granular and filamentous background accompanied by a granulomatous inflammatory infiltrate. The differential diagnosis is analyzed. The results in these cases indicate that the diagnosis of a solitary pseudorheumatoid nodule may be made by fine needle aspiration cytology after a critical evaluation of the cytologic and clinical data and with the help of special stains and microbial culture.

Arthritis, Rheumatoid↗