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Biomedical subjects

M Atienza

Publications and source records attributed to M Atienza.

32 records · Page 2Linked to original sources
PubMed1994

Primary aneurysmal cyst of soft tissues (extraosseous aneurysmal cyst)

In this report we describe a soft-tissue aneurysmal cyst located in the left shoulder of a 20-year-old woman. Although the tumor initially was clinically considered a myositis ossificans, the microscopic features were identical to those found in classic aneurysmal bone cyst (ABC). Light microscopy showed a lesion composed of a peripheral band of mature trabecular bone surrounding a multicystic central area made up of anastomosing cavernous blood channels separated by fibrous septa that contained osteoid, mineralized myxochondroid material and osteoclastic giant cells. Whereas most bone tumors have an extraosseous counterpart, ABC has been found outside the bone only once, in an artery, but never in soft tissues. Moreover, major reviews state that aneurysmal bone cyst occurs exclusively within bones. This unique case is a very rare occurrence of one of these lesions in the soft tissues.

Adult↗
PubMed1994

[Extrahepatic portal vein aneurysm and recurrent cholestasis].

Aneurysm of the portal vein is quite infrequent and its clinical manifestations is variable. The association between aneurysm of the extrahepatic portal vein and recurring obstructive jaundice has only been described on one occasion, one where there was also portal hypertension. One case of aneurysm of extrahepatic portal vein associated with recurring cholestasis is described. The diagnosis was performed via echography and abdominal TAC and confirmed by portal venography. There was no evidence of hepatopathy or portal hypertension. Possibly, the displacement of the biliary tract the portal vein is a contributing factor to recurring cholestasis in the present case.

Aneurysm↗
PubMed1994

[CT-guided fine-needle thoracic aspiration puncture. Its cost effectiveness and complications].

OBJECTIVE: To study the profitability and complications of the puncture aspiration with thoracic thin-needle (PATTN). METHODOLOGY: The results of 160 PATTN, performed under TC control in 131 men and 29 women, average age 61.24 +/- 15.17 years were analyzed. The diagnosis obtained by PATTN was compared with the definitive diagnosis made with biopsy (bronchial, thoracotomy, or mediastinoscopy), the evolution or response to treatment, or at autopsy. Factor related to greater diagnostic reliability and risk of pneumothorax were analyzed. RESULTS: For the diagnosis of non-tumoral pathology, the technique achieved a sensitivity (S) of 90 percent, specificity (E) of 96.06 percent, and reliability (F) of 91.71 percent, while in malignant processes, S 72.4 percent, E 100 percent and F 88.52 percent, with a histological correlation of 72.72 percent in the first case and 68.80 percent in the second. The localization in superior lobes, radiological pattern of multiple or cavitied nodules, and size > 2 cm were identified as factors which significantly increased reliability. Pneumothorax was produced in 24 cases (15 percent) and was more common in patients diagnosed of COPD, with a lesion < 2.1 cm, and not attached to the pleura. CONCLUSIONS: The PATTN offers considerable profitability for the diagnosis of thoracic lesions of any localization and nature, at low costs and with few serious complications.

Adolescent↗
PubMed1994

Value of CT-guided fine needle aspiration in solitary pulmonary nodules with negative fiberoptic bronchoscopy.

The usefulness of fine needle aspiration (FNA) with CT-guidance was evaluated in the diagnosis of solitary pulmonary nodules (SPN) following negative fiberoptic bronchoscopy in 84 patients. The records were analyzed for all patients with SPN who had undergone chest FNA in the years 1988 to 1990, showing previous nondiagnostic fiberoptic bronchoscopy. A final diagnosis was made by biopsy (transbronchial, thoracotomy or necropsy), response to therapy or follow-up of the lesions. The patients had medium-sized lesions, 2.87 +/- 1.11 cm, adherent to the pleura in 62%. In the diagnosis of malignancy FNA showed 76% sensitivity, 100% specificity, 100% positive predictive value, 52% negative predictive value and 81% accuracy. These results were correlated with histology in 84% of the cases. One pulmonary hemorrhage, which resolved spontaneously, and 12 cases of pneumothorax, requiring a thoracic tube in 4 patients, were noted.

Biopsy, Needle↗
PubMed1990

[Unusual bone tumor in a hemophiliac patient. Diagnosis using aspiration biopsy of the lesion].

Bone tumors due to repeated haemorrhages in haemophiliacs (haemophilic pseudotumours) usually are no diagnostic trouble. However, when x-ray findings are not conclusive, the differential diagnosis with malignant tumours may be difficult as bleeding complications hinder invasive diagnostic procedures. A fifteen year-old patient with severe haemophilia A is presented, who had a tumor in his left fibula with no previous traumatism. X-ray and CT scan images showed a broken cortical substance with reactive sclerosis and no alteration of the soft tissues. In order to establish the diagnosis and choose the adequate surgical management, aspiration with thin needle was performed through the cortical hole, under visual control with CT scan. A benign lesion was found upon study of the aspirate. No haemorrhagic or infectious complications developed after tumor dissection and filling with heterologous lyophilized bone. The final diagnosis was "giant cell reparative granuloma", an uncommon lesion in the fibula not previously reported in haemophiliacs. It was concluded that aspiration, when appropriately applied, may be a useful diagnostic procedure which should be borne in mind for the diagnosis of bone tumors in haemophiliacs.

Adolescent↗
PubMedDate not supplied

Response latencies and event-related potentials during the gap paradigm using saccadic responses in human subjects.

An experiment was conducted in naive human subjects to measure the time benefits of the latencies of saccadic eye movements to peripheral targets when the offset of a central fixation point precedes the switching on of the peripheral target by 200 ms. Naive subjects produced a shift advancement of the eye movement latencies to the targets with respect to when there is no such temporal gap. Simultaneously, the event-related potentials produced by visual stimuli and saccadic eye movements were recorded. The switching on of the central fixation point induced a negative component that could be considered a contingent negative variation. Subsequently, in the control non-gap condition visual evoked potentials and P300 appear. The temporal gap paradigm induced offset visual-evoked potentials and a frontal negativity; it also induced a higher P300 than the non-gap condition. The saccadic ERPs also showed a frontal negativity preceding the saccade during the gap condition. The results suggest that fast regular saccades during the gap paradigm occur by a priming of premotor and motor frontal circuits indexed by the recorded negativity during the gap paradigm.

Adult↗
PubMedDate not supplied

State-modulation of cortico-cortical connections underlying normal EEG alpha variants.

Normal electroencephalographic (EEG) alpha variants appear during relaxed wakefulness with closed eyes, drowsiness period at sleep onset, and rapid eye movement (REM) sleep in bursts without arousal signals. Previous results revealed that fronto-occipital and fronto-frontal alpha coherences became weaker from wakefulness to drowsiness, and finally to REM sleep. The present work was aimed at determining whether a generalized or a unidirectional deactivation of the long fronto-occipital fasciculi, previously proposed to be involved in the alpha rhythm generation, could explain the above-mentioned results. Polynomial regression analyses, applied to the change of alpha coherence with distance along the antero-posterior axis, suggested that the anterior and posterior local circuits show a similar level of activation in all brain states. Bivariate partial correlation analyses between local alpha coherences revealed that such local circuits maintain a reciprocal dependency during wakefulness, but unidirectional during drowsiness (anterior-to-posterior, A-P) and REM sleep (posterior-to-anterior, P-A). From these findings, both anterior and posterior cortical structures are suggested as being involved in the generation of the three alpha variants. If the implication of a double cortical generation source (anterior and posterior) of alpha variants is assumed, these two generators seem to maintain a mutual inter-dependency during wakefulness, whereas during the transition to human sleep, the anterior areas work quite independently of the posterior regions. Finally, the occipital structures may be the driving force for the REM-alpha bursts generation, since involvement of frontal regions demonstrated a high dependence on the posterior neural circuits in the genesis of this sleep event.

Adult↗
PubMedDate not supplied

[Stability of an oral liquid morphine formulation for pediatric use].

OBJECTIVE: The aim of this study the determination of the stability of an oral morphine hydrochloride solutions. METHOD: Determinations of a concentrated morphine solution of 4 mg/ml and the impact of two temperatures, 4 degrees C (refrigerator) and 25 degrees C (room) was analyzed via spectrophotometric measurements. RESULTS: Findings showed the high stability of the solutions at 4 degrees C, since no significant degradation was observed during the 30 days of the study, whereas at room temperature stability losses were hardly seen during the first 7 days, reaching 6.8% +/- 0.5% after 15 days. CONCLUSIONS: The tested morphine solution is stable at 4 degrees C during 30 days, but not at room temperature.

Child↗
PubMedDate not supplied

Intravitreal ganciclovir for cytomegalovirus retinitis in patients with AIDS.

OBJECTIVE: To assess the evolution of cytomegalovirus (CMV) retinitis and evaluate the possible complications associated with the use of intravitreal injections to treat this disease. DESIGN: A nonrandomized, retrospective study with case series was performed. The study took place over 34 months. SETTING: The study included patients with AIDS who developed CMV retinitis, and who were treated in the hospital, as outpatients, or both. PATIENTS: Twelve patients with AIDS and CMV retinitis diagnosed between June 1990 through April 1993 were included in the study. MAIN PATIENT PARAMETERS AND OUTCOME MEASURES: For each patient, the following data were recorded: age, risk factors, other systemic findings, dates of AIDS and CMV retinitis diagnoses, stage of AIDS, extent of the retinitis, CD4 lymphocyte count at the time of diagnosis of retinitis, visual acuity, clinical evolution of the ocular infection, therapy, complications caused by the treatment, development on nonocular CMV, and the use of zidovudine or didanosine during the study period. RESULTS: Vision improved or remained stable in nine patients and worsened in three. Two patients developed optic neuritis. The retinitis progressed to the other eye in only one of the eight patients who had unilateral involvement. The rate of relapse with maintenance therapy was 8.3% (n = 1) within the first 8 weeks. Treatment was well tolerated. There was no evidence of toxicity after a total of 226 intravitreal ganciclovir injections. All patients were able to tolerate zidovudine or didanosine concomitantly with intravitreal ganciclovir. CONCLUSIONS: Intravitreal ganciclovir appears to be an effective alternate to systemic ganciclovir in patients with severe neutropenia and in patients who choose to continue receiving systemic zidovudine or didanosine. Early treatment and long-term maintenance therapy is essential for preserving sight.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

[Carotid endarterectomy. Analysis of 193 consecutive cases].

In the last years, several randomized and multicenter trials have been performed to evaluate the benefit of carotid endarterectomy (CE) in the carotid stenosis. To determine whether CE could be performed safely at hospitals not included in international trials, the results of 193 consecutive CEs performed during a 10-year period at a medical center of our environment were reviewed. A 65.8% of CEs were performed on symptomatic patients, 68.5% of whom had stenosis superiores to 70%. Among asymptomatic patients, 89.4% had stenosis superiores to 70%. Three patients died. Besides there were five nonfatal neurologic complications (one reversible ischemic neurologic deficit, one minor stroke and three major strokes). The mortality rate was 1.5%, the rate of mayor neurologic morbidity and mortality was 3.1% and the rate of total neurologic morbidity and mortality was 4.1%. These data demonstrate that CE can be performed with safety at Divisions of Vascular Surgery of our environment.

Aged↗
PubMedDate not supplied

[Cerebral mapping during sleep: a critical review of literature].

INTRODUCTION: Cerebral mapping is a useful tool which permits graphic representation of certain EEG characteristics which are imperceptible on simple visual inspection. This technique offers quite a good solution to analysis of cerebral rhythmicity, by including spectral, spatial and statistical parameters. Sleep is a physiological process during which dynamic interchange of cerebral rhythms has an important part in delimiting the different phases, not to mention the decisive part played by phasic events at each stage of it. DEVELOPMENT: In this paper we review the studies which have used cerebral mapping techniques during the different stages of sleep. In order to give structure to the data obtained from these papers, we have classified the information into aspects related to the methodology used in these studies and the results obtained. Decisions regarding methodology are discussed, and further information given regarding technical aspects which might have had decisive influence on the results obtained using this technique. CONCLUSIONS: We give suggestions as to the possibilities of the use of cerebral mapping in studies on sleep, both clinically and experimentally.

Brain↗
PubMedDate not supplied

[Clinical value of EEG coherence as electrophysiological index of cortico-cortical connections during sleep].

OBJECTIVE: The technique of EEG coherence gives a non-invasive objective index of the functional relations between the different regions of the cerebral cortex. The main objectives of this study were firstly to obtain methodological information to facilitate its use in any context, whether clinical or in investigation, and secondly to draw attention to the results obtained with this technique during the different phases of sleep, both in healthy persons and in certain clinical conditions where its use in evaluation and/or diagnosis has been shown. DEVELOPMENT: The results derived from the application of coherence analysis during normal sleep show the existence of a high level of interhemisphere connectivity during all phases of sleep. This result has fomented its use in the evaluation and diagnosis of disorders in which it is suspected that there are anomalies in the relation between the two hemispheres, such as neurological changes (agenesis of the corpus callosum, AIDS), psychiatric disorders (depression) and in the prognosis of states of coma. Also, progressive neurone degeneration and neurochemical deficits characteristic of Alzheimer-type dementia suggest that the coherence EEG during the REM phase may give electrophysiological indices in the establishment of the diagnosis and prognosis of the disorder. CONCLUSION: This study shows that the coherence technique is a useful tool when establishing the pattern of cortico-cortical interactions subjacent to different functional states of the brain, both in healthy persons and in those with the different diseases in which there are alterations in cerebral function.

Arousal↗
PubMedDate not supplied

[Thiamine stability in parenteral nutrition].

In the present work we have studied the stability of thiamine by HPLC in parenteral nutritions provided with or without lipids. As source of nitrogen we have used Freamine 8.5%. Thiamine came from the multi-vitamin complex Pancebrin. The results of this study show that this vitamin is not stable for more than 24 h, even if parenteral nutritions are kept at 4 degrees C, except for solutions that do not contain lipids and are kept at 4 degrees C. Light does not influence the degradation rate of thiamine.

Drug Stability↗