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Biomedical subjects

M Cuesta

Publications and source records attributed to M Cuesta.

10 recordsLinked to original sources

The impact of intraoperative ultrasonography of the liver on the surgical strategy of patients with gastrointestinal malignancies and hepatic metastases.

Intraoperative ultrasonography (IOUS) of the liver is a very useful tool during surgery for gastrointestinal tumors or hepatic tumors. In a prospective study of 82 elective operations for 57 gastrointestinal tumors and 25 hepatic tumors or metastases, we compared IOUS with preoperative ultrasonography, CT-scanning and MRI. IOUS supplied additional information in 38% of the operations. In 22% of the cases, this had a major impact on the intraoperative strategy with an alteration of the procedure. IOUS has a higher detection rate of intrahepatic lesions, discriminates better between solid or cystic nature of the tumor and offers the possibility of performing a safe and radical hepatic resection by its ability to localize lesions in relation to vascular structures. IOUS is a safe and simple technique which will be more cost-effective than extensive preoperative evaluation of the liver. It provides a more complete clinical staging of patients for whom adjuvant therapy is considered after resection of a colorectal carcinoma.

Adult

Extensive disobliteration of the aorto-iliac and common femoral arteries using the LeVeen plaque cracker.

In 1978 LeVeen et al. described an original technique for extended aortobifemoral disobliteration using a retroperitoneal approach. This technique was introduced to Europe by Widdershoven and Willekens in 1977 and was adopted in Belgium by Suy and Nevelsteen in 1982 and in Spain by Cuesta and Bengoechea in 1984. A group of 228 patients treated by the LeVeen's method from 1982 to 1987 were followed-up for a mean of 21 months (1-54). Disabling claudication (66%) or more advanced ischaemia (34%) was the indication for treatment. An aorto-bifemoral endarterectomy was performed in 124 patients. Aorto-biiliac endarterectomy in 39, unilateral aortofemoral endarterectomy with a contralateral aorto-iliac endarterectomy in 17 and unilateral iliofemoral endarterectomy in 48 cases. There were seven postoperative deaths (3%) and an early thrombectomy had to be performed in 8 patients. There were 14 late deaths. Occlusion occurred in 11 patients giving a 3-year-patency rate of 97%. There were no late complications related to the technique. It is concluded that disobliteration using the LeVeen technique compares well with prosthetic grafting. Since this method does not require the use of foreign material the patient is protected from the complications sometimes seen after the insertion of prosthetic grafts.

Aorta, Abdominal

Fatal compulsive water drinking.

In two cases of psychogenic polydipsia, water intoxication developed and contributed to the patient's death. The treatment of the patient with psychogenic polydipsia has been based on the presumed reversibility of the condition. Treatment of such patients must be reconsidered in light of these deaths.

Adult

Pneumococcal septic arthritis as the first manifestation of multiple myeloma.

In this paper we report a 47 year old woman with septic arthritis due to Streptococcus pneumoniae. No known predisposing factor was found. After an extensive workup a multiple myeloma was discovered. In our case septic arthritis was the first manifestation of multiple myeloma.

Arthritis, Infectious