PubMed Health⌕ Search

Biomedical subjects

M García García

Publications and source records attributed to M García García.

At least 19 recordsLinked to original sources
PubMed2005

[Ischemic renal disease: revascularization or conservative treatment?].

Ischemic nephropathy is recognized as a distinct cause of renal insufficiency and it is defined as a significant reduction in glomerular filtration rate in patients with hemodynamically significant renovascular occlusive disease. We argue the epidemiologic and clinical manifestations of atherosclerotic renovascular disease, and we evaluate the pronostic agents. Published studies of the outcome of revascularization for renal-artery stenosis have been excellent, offering a durable patency and functional improvement but they have had numerous limitations. The atherosclerosis is a systemic disease and it provides the general prognosis of patients. We conclude that ischemic renal disease is a nephropathy of smoker men, with proteinuria excretion similar to nephropathy with unilateral stenosis. The age of patients is the clinical feature that decide the treatment: surgery, angioplasty/stent or medical management. Comparative analysis of percutaneous transluminal angioplasty and operation for renal revascularization and medically treated patients have proved that the advanced chronic renal insufficiency is associated with an unfavourable response of treatment of the ischemic nephropathy. But, in this nephropathy the revascularization can be the better therapy for selected patients. The revascularization with angioplasty/stent for patients with unilateral renal stenosis and chronic renal insufficiency has a doubtful effectiveness, as the chronic renal failure is result of nephroangiosclerosis.

Adult↗
PubMed2005

[Diagnosis and prognosis of atheroembolic disease].

Atheroembolic disease is recognized as an iatrogenic complication from an invasive vascular procedure, such as manipulation of the aorta during angiography or vascular surgery, and after anticoagulant and fibrinolytic therapy. Cholesterol crystal embolism is caused by showers of cholesterol crystals from an atherosclerotic aorta that occlude small arteries. The kidney is a frequent target organ for cholesterol emboli because of proximity of the renal arteries to abdominal aorta and it receive an enormous amount of blood flows. We describe the epidemiologic agents of 19 cases that were diagnosed by histologic sections of the affected tissues; the eosinophilia and the renal failure are the clinical features that guide to the diagnosis, in patients with ischemic nephropathy and general atherosclerosis. 53% among patients had a previous invasive procedure and 26% occurred spontaneously. We remark the importance of the kidney's biopsy in diagnosis of the atheroembolic disease and their bad prognosis with 63% of death rate in 18 months of average follow-up. We report patients with the multiple cholesterol emboli syndrome mimicking systemic vasculitis: they died by multivisceral acute failure. The subacute presentation of atheroembolic disease with progressive renal failure treated with hemodialysis is a sign of bad prognosis. The knowledge of the disease and their prevention are the better treatment.

Adult↗
PubMed2001

[Bronchiolitis and persistent wheezing. Is eosinophilia a risk factor?].

OBJECTIVES: To investigate the final outcome of infants presenting an episode of bronchiolitis and to analyze the risk factors for the development of persistent wheezing, with special attention paid to the presence of eosinophilia during the acute episode. PATIENTS AND METHODS: We studied all the children aged less than 2 years who required hospitalization for bronchiolitis between 1990 and 1993. Eosinophil values during the acute phase were collected. Clinical evolution and outcome were classified in three groups: short-term persistent wheezing (if resolved before the child reached the age of 5 years), long-term persistent wheezing (if the child remained symptomatic after the age of 5 years) and no wheezing. Other risk factors for asthma such as familial history, passive smoking and respiratory syncytial virus isolation were also studied. RESULTS: We analyzed 170 patients (100 boys and 70 girls) aged 7.15 6 0.78 years who suffered an episode of acute bronchiolitis at the age of 5.4 4.2 months. One hundred thirteen patients (66.5 %) developed short-term persistent wheezing and 60 (35.3 %) developed long-term persistent wheezing. Fifty-six patients presented no wheezing. The number of patients with eosinophils > 1 % was significantly different in the three groups of patients (p 5 0.029). A Eosinophil values of > 1 % was associated with short-term persistent wheezing (p 5 0.013). Mean eosinophil values were higher in patients who developed wheezing at some time during evolution (p 0.028). A familial history of asthma was associated with the development of long-term persistent wheezing (p 0.033). CONCLUSIONS: In the population studied, eosinophil values of > 1 % during an episode of acute bronchiolitis in infancy was associated with a higher risk of developing persistent wheezing in the first 5 years of life. A familial history of asthma was associated with a higher risk of developing long-term persistent wheezing.

Asthma↗
PubMed1997

[Laparoscopic fenestration in the management of symptomatic polycystic liver disease].

We report the case of a 70-year-old woman with polycystic disease of the liver and kidney, complicated with rupture and hemorrhage of the hepatic cysts located in the right lobe. A laparoscopic approach was used. After identifying the polycystic mass, the cytologic examination of the aspirated hematic fluid and the intraoperative biopsy showed its benign nature. An hepatic fenestration was performed. Hemostasis was achieved by electrosurgical and argon probes. The postoperative course was satisfactory and radiological improvement was demonstrated on the CT scan 3 months later. Follow-up examination one year later has been uneventful. Fenestration is one of the less stressing surgical options in the adult polycystic liver disease when treatment is indicated. The laparoscopic approach may be used with safety to perform a similar technique in selected cases, establishing a communication between the cysts and the peritoneal cavity. Nevertheless, it may be difficult to reach deeply situated cysts and to differentiate them from vascular structures. Laparoscopic intraoperative ultrasonography might be of great value in these cases. Likewise, long term studies are needed to determine the benefits and the indications of the laparoscopic fenestration.

Aged↗
PubMed1995

[The perceptions of family physicians of the physician-patient relation].

OBJECTIVE: To identify family doctors' (FD) perceptions of the doctor-patient relationship and the factors conditioning those perceptions. DESIGN: A descriptive crossover study. Using the technique of the discussion group, the contributions of FD from both the rural and urban areas were collected. The discussion was taped, transcribed (language and paralanguage) and analysed inductively. SETTING: Health centres in Navarra. PARTICIPANTS: 12 urban and 8 rural FD were chosen in order to include those variables (sensitivity to the question, professional field, age, years of experience and gender) which would lead to both a wide-ranging discussion and joint work. RESULTS: The FD felt they were little valued and had lost responsibilities. Patients were perceived negatively on the whole and doctors' relationship with them was lived as something unsatisfactory and full of obstacles. "Difficult" patients, along with the possibility of committing technical errors, were clearly matters of concern. Although the responsibility of external factors was emphasised, the need to reconsider their own behaviour was recognised, as was the need for special training to improve their relationships with patients. CONCLUSIONS: The attitudes of FD do not make the construction of positive relationships with patients easy and can lead into a process of serious professional and personal frustration. Neutralising this process, through a series of measures not restricted to training, is a priority in primary care development.

Attitude of Health Personnel↗
PubMed1995

Effects of chronic alcohol exposure on the morphometric development of medial preoptic area neurons of the male mouse.

We have performed a karyometric study of the medial preoptic area of male mice from mothers that ingested chronically a solution of 20% of ethanol added to the drinking water. Pups then were exposed prenatally to alcohol. After parturition, pups were also exposed to alcohol, first through their mother's milk and after weaning by direct ingestion of the same solution of 20% of alcohol until the day of sacrifice. Animals were sacrificed at the 25th, 35th, 45th, 55th and 100th day and the results compared with those obtained in another group of control animals, sacrificed at the same ages. Chronic alcohol exposure reduces the studied nuclear sizes (perimeter, area and maximum diameter) in adult animals of 100 days of life, but does not produce significative changes in nuclear sizes of younger animals. However, nuclear shape, another of the nuclear parameters analysed, did show significative alterations in relation with the puberal age. These morphometric effects could be due to the reduction of plasmatic testosterone levels produced by alcohol and/or to a direct toxic effect of the alcohol on central nervous system neurons.

Alcohol Drinking↗
PubMed1995

[Pollakiuria and idiopathic hypercalciuria in childhood].

OBJECTIVE: To determine the incidence of pollakiuria in children with idiopathic hypercalciuria. METHODS: The clinical records of 56 children with idiopathic hypercalciuria were reviewed. In addition to pollakiuria, they were evaluated for other associated disorders, maximum urinary osmolality, urodynamic study and overall clinical course. RESULTS: Nine children (16%), 4 boys and 5 girls, presented with pollakiuria associated with urgency, nocturnal enuresis, hematuria and urinary incontinence. Two showed normal urodynamic studies and unstable bladder was observed in another case. All but one patient preserved normal renal concentration capacity. The course of the micturition symptoms was satisfactory and only three cases required pharmacological treatment. CONCLUSIONS: In the absence of urinary infection, pollakiuria might suggest the presence of hypercalciuria, a condition that can be managed successfully following correct diagnosis and treatment. Renal concentration capacity is not reduced by hypercalciuria.

Calcium↗
PubMed1993

[Kawasaki disease; complications and clinical course. Apropos of 38 cases].

Between January 1978 and December 1991, 38 patients who fulfilled the CDC (Center for Disease Control) criteria for Kawasaki syndrome were admitted to our hospital. We reviewed the clinical data, laboratory tests, ECG and serial echocardiographic studies in order to establish the characteristics of the disease in our environment. There were 23 males and 15 females. The age at presentation ranged from 4 months to 10 years (mean 3.5 years). Extracardiac complications were as follows: arthritis in 12 patients, vesicular hydrops in 2, urinary tract infection in 1 and lymphocytic meningitis in 1. Cardiac involvement was frequent, with 35% of the patients being diagnosed with coronary pathologies (dilatation of coronary arteries in 9 and aneurysm formations in 4). The most usual location of these anomalies was in the left main coronary artery. By the end to the follow-up period, 71% of the lesions had disappeared. The time necessary for this regression was related to the size of the abnormalities. The high incidence of cardiac involvement make it necessary to follow these patients for a period of time in order to prevent or to treat the later occurring sequelae.

Arthritis↗
PubMed1989

[Cancer of the gallbladder].

A retrospective study was made of cancer of the gallbladder over a 10-year period, during which 874 operations of the biliary tract were performed, 26 for gallbladder neoplasm (2.97%). Of the 26 patients studied, 22 (84.6%) were women, mean age at appearance of the tumor being 63.9 years. In 77% of the patients the time of evolution of the symptoms was less than a year, a men of 3.6 months. The principal symptom was abdominal pain, encountered in 96% of patients, followed by nausea and vomiting (65.4%). Fifty-eight percent of patients had gallstones and 46% had metastases at the time of operation. In 23% of the patients only laparotomy and biopsy could be performed, 42% underwent cholecystectomy and 34% cholecystectomy and drainage of the biliary tract. Of the 26 patients in our study, 24 (92%) had adenocarcinoma.

Adenocarcinoma, Papillary↗