PubMed Health⌕ Search

Biomedical subjects

J Vargas

Publications and source records attributed to J Vargas.

At least 145 records · Page 8Linked to original sources
PubMedDate not supplied

[Double outlet right ventricle with discordant atrioventricular connection. Clinical study].

The clinical and anatomic findings were reviewed in 17 patients with double-outlet right ventricle and atrioventricular discordance. Ten cases had atrial situs solitus, seven with right-sided heart three with left-sided heart. Seven cases had atrial situs inversus, five with left-sided heart and two with right-sided heart. All cases presented ventricular septal defect, 13 subvalvar pulmonary stenosis, two tricuspid regurgitation and two complete atrioventricular block. The spatial relationship between the arterial valves are variable. Most cases in atrial situs solitus had a left-sided and anterior aorta and all patients in atrial situs inversus had a right-sided and anterior aorta. In this study we compared the anomalies found in our cases with double outlet right ventricle with those in 58 patients with corrected transposition. Absolute, relative and attributable risks were calculated for the presence of subvalvular pulmonary stenosis, ventricular septal defect, tricuspid regurgitation and atrioventricular block for each the two groups. We concluded that patients with double-outlet right ventricle are more prone to present ventricular septal defect and subvalvar pulmonary stenosis, while those with corrected transposition have a greater likelihood of presenting with tricuspid regurgitation and atrioventricular block. There is no typical clinical picture for the malformations. Symptoms depend upon the associated anomalies. The final diagnosis is best achieved by the echocardiographic and angiocardiographic studies, but electrocardiogram and chest radiograph may suggest the presence of a discordant atrioventricular connection.

Adolescent↗
PubMedDate not supplied

Diagnosis and management of chronic intestinal pseudo-obstruction syndromes in infancy and childhood.

Chronic intestinal pseudo-obstruction is a rare disorder characterized by ineffective intestinal propulsion in the absence of mechanical factors. It depends on isolated or associated disturbances of intrinsic and extrinsic innervation of the smooth muscle, neurotransmitters and hormones. In children the most common causes are postoperative paralytic ileus, pneumonia or pancreatitis, occurring usually in the first year of life. There is also hereditary transmission, comprising the familial visceral myopathy (hollow visceral myopathy) and the familial visceral neuropathy. The pseudo-obstruction may be associated with congenital anomalies (digestive or not) in 10 to 30% of the cases, mainly malrotation, pyloric stenosis and bladder atony. Diagnostic difficulties may lead to exploratory laparotomy. A precise diagnosis requires judicious interpretation of radiologic, manometric, radioisotopic and hystologic findings. Medical treatment includes drugs acting on gastrointestinal motility as well as hydroelectric and nutritional support, besides treatment or prevention of infections. It is possible that in the future these patients may be treated by surgical implantation of electrodes promoting gastrointestinal myoelectrical stimulation.

Child↗
PubMedDate not supplied

[Congenital intrapericardial parietal aneurysm of the left atrium. The electrocardiogram and echocardiogram as methods of diagnostic value].

A case of congenital intrapericardial aneurysm of the left atrium associated with functional mitral insufficiency is described; it was resected successfully. Clinical, radiographic, vecto-electrocardiographic, ecocardiographic and angiocardiographic findings are shown. Those are compared with those of other nine similar cases. The finding of qR or QS complexes in L-I and a VL in the electrocardiogram as a sign of left atrial enlargement and eco-fre space posterior to the left ventricular endocardium in the ecocardiogram is mentioned as useful data in the diagnosis of left atrial aneurysmal dilatation not previously reported. Considering that the surgical result is always good, it is concluded that the congenital intrapericardial aneurysm of the left atrium is a rare malformation which needs to be resected irregardless of the presence or absence of arrhythmias, embolisms or heart failure.

Child↗
PubMedDate not supplied

[Electrocardiogram in interstitial pneumonia. Electrocardiographic-hemodynamic correlation].

Twenty four patients with interstitial pulmonary disease from the Cardiopulmonary Service of the Instituto Nacional de Cardiología were studied. Surface electrocardiograms and pulmonary hemodynamic studies were registered to all patients in order to obtain the pulmonary vascular resistances and pressures to find out the electrocardiographic-hemodynamic correlation. Three groups were made according to the pulmonary artery sistolic pressure: Group I, 30 to 45 mm Hg (6 patients); Group II, 46 to 70 mm Hg (12 patients) and Group III more of 60 mm Hg (6 patients). Also, arterial gaseous partial pressures were determined, among other pulmonary test parameters. Electrocardiographically, the rhythm, A=V node conduction, AQRSF, APF, atrial and ventricular hypertrophy, intraventricular conduction and ventricular repolarization were studied in leads II, III, aVF, aVR, V1, V2, V3 and V6. The characteristics of the ventricular repolarization and depolarization processes of each group are described, in order to discuss the mechanism of the anormalities. Finally, the electrocardiographic findings were correlated with the different degrees of pulmonary arterial hypertension; the conclusions are: I. The electrocardiogram allows us to differenciate the patients with III degree of arterial pulmonary hypertension, from those of I and II degrees. II. Patients with I and II degrees of pulmonary arterial hypertension determine nearly the same electrocardiographic alterations; the mean differences to establish the differential diagnosis is the AQRSF, shifted to the right and upwards, in the II degree of pulmonary arterial hypertension.

Adult↗
PubMedDate not supplied

[Apical hypertrophic myocardiopathy. Report of the first case identified on the American continent].

What appears to be the first case of hypertrophic apical myocardiography described in the western hemisphere is presented in this report. The diagnosis was confirmed by angiocardiography and echocardiography. The electrocardiogram showed the characteristic giant T waves. It is of interest that the coronary radioangiography suggested alterations in the microcirculation which could explain the striking electrocardiographic pattern of subepicardial ischemia seen in these patients.

Adult↗
PubMedDate not supplied

[Disorders of the right intraventricular conduction in chronic pulmonary hypertensive cardiopathy].

Disorders of the right intraventricular conduction were analyzed in cases of chronic pulmonary hypertensive cardiopathy (C.P.H.C.), diagnosed on basis of the anatomic data. The series studied here (40 cases) was obtained from the review of 3,000 reports of autopsies at the Instituto Nacional de Cardiología de México. Thickness of the free right ventricular wall, thickness of the interventricular septum at three levels, thickness of Wolf's spur and the circumference of the 4 valvular rings, were determined in each heart. Haemodynamic studies and respiratory function tests were revised in those cases in which they had been practiced. Electrocardiographic study essentially analyzes the time of onset of intrinsicoid deflection as well as the morphology of ventricular complexes in the unipolar leads. In 37 cases (92.5%), a disturbance of the right intraventricular conduction was present. R.B.B.B. was observed in 29 cases (72.5%): 12 of minor degree, 19 of intermediate and 1 of advanced degree. Right peripheral block was diagnosed in 8 cases (20%): anterior type in 2 cases (5%); posterior type in 6 cases (15%). In the cases with R.B.B.B., the anatomic data of right ventricular hypertrophy were predominant; in those with R.A.S.B., anatomical data suggested right ventricular enlargement. The facts exposed here permit the following conclusions: 1) Diagnosis of right fascicular block can be suggested even in the presence of hypertrophy of the corresponding ventricle. 2) Hypertrophy of the right ventricle appears more directly related to the homolateral bundle branch block than to distal or segmentary blocks. 3) Topographic diagnosis of delay in the right ventricle activation process can be established by an electrocardiographic thoracic mapping that permits to explore the ventricular structures at different levels.

Adolescent↗
PubMedDate not supplied

[Pulmonary arterial hypertension in disorders of oxygen diffusion].

UNLABELLED: Twenty three cases with impairment of greater than 40% of DLCO were studied in a search of frequency, severity and pathophysiological mechanisms of PAH. Hemodinamic studies, pulmonary angiography (PA), lung scan (LS), lung biopsies (LB) were performed. The venous admixture was estimated and expressed as percentage ratio of the cardiac output (Qva/Qt x 100). Anatomical pulmonary artery to vein shunt (Qs/Qt) was estimated breathing pure O2. Ninety one percent of cases had PAH; mild to moderate in 76% of cases. Cardiac index (CI) was less than 2.8 in 26% and greater than 4.2 in 39%. The right ventricular work index (RVWI) was greater than 1.25 in 86%. The alveolar arterial oxygen tension gradient (A-aDO2) was abnormal in all cases (greater than 18 mmHg) with a Qva/Qt of greater than 30% in 78% of these cases. The Qs/Qt was found 6% in 39% of cases. IN CONCLUSION: PAH was mild to moderate in DL impairment. The RVWI was usually increased with a normal or high CI. Increase in Qva/Qt that result from V/Q abnormalities and extreme impairment of DL is to be considered as the major factor functional features in the genesis of PAH. Reduction of the cross sectional area of the pulmonary vascular bed and lung function abnormalities are equally important relevants features in the genesis of PAH.

Adult↗
PubMedDate not supplied

[Double outlet chamber from the right ventricle with restrictive interventricular communication].

We report two cases with double outlet right ventricle and subaortic restrictive ventricular septal defect. Both had atrial situs solitus and atrioventricular concordance. There were no other associated defects. Both cases were diagnosed by means of an angiocardiographic study and case two was also studied anatomically. Additional data for the diagnosis were findings of left ventricular overload by the EKG; left atrial enlargement and signs of venocapillary hypertension by the chest X-rays; left ventricular/right ventricular pressure gradient by the hemodynamic study and the angiographic findings. One case had mitro-aortic discontinuity. Case two had a double infundibulum, being the left one the responsible for the restrictive ventricular septal defect. We conclude that double-outlet right ventricle with restrictive ventricular septal defect cases have their own clinical, hemodynamic and angiographic features which have to be accurately studied in order to offer an adequate surgical treatment.

Aorta, Thoracic↗
PubMedDate not supplied

Fine needle aspiration diagnosis of carcinoma arising in an ectopic breast. A case report.

BACKGROUND: Ectopic breast tissue has been found at many anatomic locations. Neoplastic and hyperplastic lesions similar to those that develop in the normal breast can occur in supernumerary ones. CASE: A 45-year-old female presented with a 30-cm, firm, subcutaneous mass in the left side of the chest wall that was clinically considered an ectopic breast. Fine needle aspiration biopsy showed irregular clusters and single epithelial cells with marked atypia, pleomorphism and occasional magenta bodies. CONCLUSION: This case illustrates that fine needle aspiration biopsy is a rapid and highly specific technique that can be used as the first diagnostic step in cases of carcinoma arising in an ectopic breast.

Biopsy, Needle↗
PubMedDate not supplied

Solitary angiomyolipoma of the liver. Report of a case with diagnosis by fine needle aspiration biopsy.

Solitary angiomyolipoma is a benign tumor that rarely develops in the liver. The preoperative diagnosis of this lesion is of great value because of the therapeutic implications. Radiologic findings are relatively characteristic but not specific. A case of giant angiomyolipoma of the liver is described in which ultrasonography, computed tomography and magnetic resonance imaging were insufficient to establish the diagnosis. Fine needle aspiration biopsy (FNAB) was performed, showing bundles of smooth muscle cells intermingled with fat mature cells, characteristic of this lesion. FNAB may be a valuable method of establishing a definitive diagnosis of hepatic angiomyolipoma.

Angiomyolipoma↗
PubMedDate not supplied

Fine needle aspiration biopsy findings in endodermal sinus tumors. A report of four cases with cytologic, immunocytochemical and ultrastructural findings.

We present four cases of endodermal sinus tumor affecting children (median age, 20 months). Three tumors were located in the sacrococcygeal region and one in the right testicle. All cases were diagnosed by fine needle aspiration biopsy. The most characteristic features were cells arranged in a papillary-like configuration, vacuolated cytoplasm and intracellular and extracellular deposits of pink, homogeneous material. Immunocytochemical study showed alpha-fetoprotein-positive cells. Ultrastructural study showed intracytoplasmic inclusions of electron-dense material and basement membrane-like material in the intercellular spaces.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

[Pulmonary valve autograft for aortic valvulopathy].

Twelve patients were operated on between February 1992 and June 1993 because aortic valve disease with pulmonary autograft replacement of the aortic valve and reconstruction of the right ventricular outflow tract with a valved tube of autogenous pericardium and bovine prosthetic pericardium valve made at the Instituto Nacional de Cardiología Ignacio Chávez. Aortic and pulmonary annular diameters were taken preoperative in all patients by transthoracic echocardiography. During the surgical procedure, transthoracic echocardiography was done in order to assess valvular function of the pulmonary autograft. There was no peri-operative morbi-mortality and no anticoagulation was required. Post operative evolution was satisfactory in all patients and were discharged after transthoracic echocardiography evaluation. Annular diameters correlated with the trans-surgical annular measurements. We conclude that the use of the pulmonary autograft in selected cases can be done, in order to relieve aortic valve disease, without significant morbi-mortality as compared with single aortic valve replacement.

Adult↗