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Biomedical subjects

J Velázquez

Publications and source records attributed to J Velázquez.

At least 19 recordsLinked to original sources

Bronchial sensitivity to histamine in former asthmatics: redevelopment of symptoms during a year of followup.

The aim of this protocol was to study bronchial responsiveness in 23 former asthmatics who were free of symptoms for at least 5 years. Bronchial hyperreactivity (BHR) was evaluated with histamine challenge test and the results were compared with those of 20 normal subjects and 20 current asthmatic patients. Among the former asthmatics 65% fulfilled the criteria of BHR. During 1 year of followup, two former asthmatics redeveloped asthma symptoms. Interestingly, one patient had no BHR when initially tested. These findings suggest that the absence of BHR does not guarantee the nonrecurrence of asthma symptoms in former asthmatics.

Adolescent↗

Surgical treatment for neuroblastoma: complications during 15 years' experience.

BACKGROUND/PURPOSE: Surgery plays an important role in neuroblastoma treatment. Although influence of resectability in survival has been studied deeply, reports about surgical complications are scant. The authors analyze retrospectively their experience in neuroblastomas (NB) diagnosed from 1980 to 1995. METHODS: Clinical variables such as age, stage, location, presurgical chemotherapy, type, and extent of surgery were studied. Complications were classified according to the following criteria: time, type of surgery, and extent of resection. RESULTS: Seventy-eight NB patients had surgery performed in our hospital. Mean age at diagnosis was 2.4 years (range, 0 to 11 years); 33 patients were under 1 year of age. Sixty-eight percent of the patients had advanced disease. Abdominal tumors were predominant. Sixty-three percent of the patients had chemotherapy before surgery, with shrinkage of the tumor in most of the cases (88%). Eighty-six surgical procedures were performed, 29 initially and 57 delayed. Complete resection was reached in 52 patients, partial in 19 patients, and seven patients underwent biopsy only. There were 42 surgical complications. Three of them were considered extremely serious (one death caused by cardiac arrest, one tumoral rupture, and one great vessel injury). Nephrectomies (n = 12) were the most frequent intraoperatory complications. Bernard-Horner syndrome (n = 5) and pleural effusions (n = 5) predominated in the postoperative period. CONCLUSIONS: (1) Surgery in NB can be performed safely. (2) Nephrectomies can be necessary to achieve complete resection in some abdominal tumors. (3) Nephrectomies, Bernard-Horner syndrome, and pleural effusions were the most frequent complications in our patients. (4) Presurgical chemotherapy can lead to a wider and safer removal of locally advanced tumors.

Adrenal Gland Neoplasms↗

[Disseminated tuberculosis with cutaneous manifestations in AIDS patients. Presentation of 4 cases].

BACKGROUND: Acute cutaneous miliary tuberculosis is a rare form of Mycobacterium tuberculosis infection which has been described in only 25 published cases in the last 15 years. The appearance of serious disseminated forms of tuberculosis is enhanced by the severe immunodeficiency which characterizes AIDS. METHODS: Four cases are described of disseminated tuberculosis with cutaneous localization clinically described as the acute miliary form. Patients had AIDS and CD4 lymphocyte levels of < 100 cells/mm3. Diagnosis was established in all cases by scraping of cutaneous lesions and direct examination with Ziehl-Neelsen coloration. RESULTS: The 4 patients presented signs and symptoms of disseminated tuberculosis with cutaneous manifestations, without a definite pattern and with localization predominantly on the thorax. Three had BAAR-positive sputum. Multiresistant strains of Mycobacterium tuberculosis were confirmed by antibiogram. One patient infected by a strain sensitive to first-line drugs responded favorably to conventional treatment for disseminated tuberculosis. In the remaining three with multiresistant strains, the evolution of the disease was rapid and unfavorable. CONCLUSIONS: Abrupt appearance of cutaneous lesions in a patient with disseminated tuberculosis and advanced HIV-disease should raise the suspicion of its etiology. Scraping and direct examination using Ziehl-Neelsen coloration is practical, economical and non-invasive diagnostic method.

Acquired Immunodeficiency Syndrome↗

[Solid ovarian tumors in childhood].

We evaluate our experience in solid ovarian tumors at the Children's Hospital La Fe. The main aims of the study were finding out relevant clinical data for a correct clinical approach, and the optimal surgical attitude in order to obtain tumor relieving with preservation of fertility when possible. A review of 28 girls under 14 years with solid ovarian tumors was carried out. Previous history, initial symptoms and signs, analytical and radiological explorations, treatment and evolution were analysed. 17 benign and 11 malignant tumors were found. Main clinical data were acute abdominal pain and palpation of a mass. Surgery was performed in all of them: salpyngo-oophorectomy in 23 and oophorectomy in 5, with tumoral resection. All patients survive, with periodic follow-up. We remark the frequency of acute abdominal pain as initial symptom of an ovarian tumor, and the importance of a surgical attitude that, intending to be curative, would preserve fertility.

Adolescent↗

Pigmented basal cell carcinoma: an unusual case.

The case of a 66-year-old man who presented with an extensive pigmented basal cell carcinoma of the left cheek is reported. Treatment consisted of irradiation and staged surgical resections. The cosmetic result was excellent, and the patient has been free of the cheek tumor for 2 1/2 years. The numerous problems inherent in the treatment of patients with disfiguring facial skin malignancies were surmounted by a multidisciplinary team in which radiotherapy, plastic surgery, and dental services participated.

Aged↗

Pseudomyxoma peritonei: case report and review of the literature.

Pseudomyxoma peritonei is a rare entity manifested by implants of a mucinous gelatinous material arising from either the appendix or ovary and involves the peritoneal cavity, peritoneum and omentum. Preoperative diagnosis is feasible by means of radiographic studies. The main step in the treatment is debulking surgery with appendectomy, bilateral oophorectomy and omentectomy. Adjuvant radiotherapy and chemotherapy has been used. Long term survival is around 54% at five years. Here we present a case of a ruptured mucocele of the appendix and pseudomyxoma who presents as massive increase in the abdominal girth of two years evolution.

Aged↗

[Trichinosis: new epidemic outbreak caused by the ingestion of wild-boar sausage].

After the evaluation of 129 serum samples of persons who had ingested boar sausage infested by Trichinella spiralis, 48 individuals (40 adults and 8 children) with a mean age of 38.8 years were diagnosed of trichinosis. The incubation time was 17 days (range 2 to 44 days). The following clinical features were outstanding: facial and eyelid edema (50%), diffuse limb myalgia (43%), fever (37%), conjunctivitis (25%), headache (16%), and abdominal pain (16%). Remarkably, 33% of the diagnosed patients were asymptomatic. The diagnosis was made by an indirect immunofluorescence technique (IIF), which was considered as positive when the titer was higher than 1/20 after considering seroconversion at the beginning of the disease and after 4-6 weeks. Among laboratory abnormalities there was leukocytosis in 15 patients and eosinophilia in 37. The GOT, GPT and CPK enzymes were only slightly increased in a small proportion of patients (8, 10, and 31%, respectively). Forty patients were treated with thiabendazole, associated or not to corticosteroids, which was well tolerated. Eight patients were not treated. One year after the diagnosis a new laboratory control was undertaken in 43 patients (all asymptomatic). Eosinophilia was still present in 12, and the titers against Trichinella were high in all. However, the percentage of the titer was smaller than at the beginning of the outbreak.

Adrenal Cortex Hormones↗

Study of appendicitis in children treated with four different antibiotic regimens.

This is a prospective and randomized study of 100 patients with acute appendicitis who were less than 10 years old, in which four different antibiotic regimens commonly in use against gram-negative and anaerobic bacteria were compared in terms of postoperative septic complications. The antibiotics were begun immediately preoperatively and continued for five days. Ten percent of the patients developed infection complications, with 4% requiring further surgery. The best results were obtained with cefoxitin (4% of infection), metronidazole plus amikacin and latamoxef (8%), while the regimen of clindamycin plus amikacin was associated with the greatest number of complications (20%). On analyzing the main microbiologic findings of the study, we conclude that some sort of antibiotic treatment is indicated in all types of appendicitis, due to the occult presence of bacteria in the peritoneal cavity, even without clinical evidence of gangrene or perforation. Further, we emphasize the significance of Streptococcus faecalis as being responsible, along with Escherichia coli and Bacteroides fragilis, for serious postoperative complications.

Anti-Bacterial Agents↗