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Biomedical subjects

M Gil

Publications and source records attributed to M Gil.

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

Recognition of ERC-induced pancreatitis in patients with choledocholithiasis by an analysis of laboratory findings.

BACKGROUND/AIMS: This study retrospectively analyses the relative value of various laboratory tests in the diagnosis of procedure-related pancreatitis in patients submitted to endoscopic retrograde cholangiography with sphincterotomy due to choledocholithiasis. METHODOLOGY: A detailed laboratory assessment was performed on 238 patients 4, 10, 24, 48 and 72 hours after undergoing endoscopic sphincterotomy. RESULTS: Of the 238 patients analyzed, 16 (6.7%) had a complication, including pancreatitis in 6 (2.5%), hemorrhage in 4 (1.7%), acute cholangitis in 3 (1.3%), and perforation in 3 (1.3%). In patients developing acute pancreatitis a significant rise was noted not only in serum amylase but also in the white blood cell count and aspargine transaminase at 24 hours following endoscopic sphincterotomy. Endoscopic procedure (difficulty in cannulating the bile duct and/or obtaining cholangiogram) was a significant risk factor for complications. CONCLUSIONS: It is possible to stratify patients according to their risk of developing pancreatitis according to serum amylase, white blood cells and aspargine transaminase levels monitored for at least 24 hours following ERC. Patients for whom the procedure was difficult and selective cholangiogram was not obtained are at increased risk of developing procedure-related complications.

Acute Disease↗
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[Supravalvular aortic stenosis. Report of clinical findings in 5 patients].

Five cases of supravalvular aortic stenosis (SAS) diagnosed by heart catheterization were studied in the Instituto Nacional de Cardiologia of Mexico. The clinic and laboratory data of interest of the differential diagnosis with other forms of obstruction of the left ventricle as follows: 1. Three cases had mental retardation and "elfin" face (SAS with specific psychophysical syndrome), the rest had a normal psyco-physical state without family antecedents (sporadic SAS). 2. The aortic focus was the epicenter of the expulsion murmur. In the phoncarodiographic study, two patients had protosistolic click and another had, in addition, a descending protodiastolic murmur (Int. I-IV). In the radial sphigmograms, one case had an amplitude difference in favor of the right side. 3. All had serum calcium figures within normal limits. 4. A chromosomatic analysis of preperipheral blood was performed on two patients, with normal results. 5. In the electrocardiogram, one case had right ventricular enlargement secondary to pulmonary arterial hypertension, due to stenosis of the main pulmonary arteries. 6. The radiologic study did not show dilatation of the ascending aorta and aortic bud in any case. 7. The angiocardiography showed: stenosis directly above the Valsalva sinuses; absence of dilatation or hypoplasia of the aorta above the stenosis; and the coronary network, indirectly opaqued, showed no abnormalities. One case had aortic coarctation and abnormal implantation of the right sublaviar artery, and another, stenosis of the right and left branch of its origen of the truncus of the pulmonary artery. The literature up to the present is reviewed and an anatomo-functional classification is proposed with the objective of including new varieties.

Adult↗
PubMedDate not supplied

[Value of the electrocardiogram to predict the pattern of left ventricular contraction in ischemic cardiopathy].

A correlative electrocardiographic and ventriculographic study was performed in a series of 100 patients with clinical and electrocardiographic diagnosis of ischemic heart disease. The analysis was focused on the possibility of predicting ventricular contraction pattern (VCP) disturbances, through electrocardiographic signs of coronary insufficiency. Two main groups were separated on the basis of the presence of necrosis. There were 66 cases with necrosis, and 34 without it. The type of VCP was calssified in accordance with the criterion of Herman et al. in: asyneresis, akinesis and dyskininesis. The degree of coronary narrowing was arbitrarily evalued as less than 50%, between 50 and 75%, and over 75% of the lumen.

Coronary Disease↗
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[Detection of early occlusion of aortocoronary by-passes. Usefulness of a non-angiographic method].

A total of 83 bypasses were studied. Angiographic results demonstrated occlusion in 3 of 24 bypass of internal mammary artery placed in the anterior descending artery, 2 in the right coronary artery, 1 in the posterolateral of the circumflex and 1 in the first diagonal branch, with a total occlusion average of 8.4% within the first 8 days. We found a good correlation between the coronarographic angiograms and the positivity or negativity of the echo-electrocardiographic tests, during atrial pacing. We believe that this simple method could be done routinely in all the patients after coronary surgery, to decide the need of a new coronary angiogram. Furthermore, this study shows that the occlusion of a single coronary bypass does not produce myocardial infarction, detectable by enzymatic measures or by resting EKG. This method also detects the early post-operatory sinus sick syndrome.

Adult↗
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[Percutaneous mitral commissurotomy with Inoue balloon. Short-term results. Initial experience at the Ignacio Chavez National Institute of Cardiology].

Percutaneous transvenous mitral commissurotomy (PTMC) using balloon catheters has emerged as an alternative to surgery for patients with mitral stenosis. This report details our recent experience of PTMC with the Inoue balloon in 20 consecutive patients with mitral stenosis from april 2 to july 27, 1991. Mean age was 35.6 +/- 9.5 years. Mitral valve area increased form 1.04 +/- 0.3 to 2.32 +/- 0.5 cm2 (p less than 0.0001). Mitral valve gradient decreased from 19.2 +/- 8.8 to 6.6 +/- 2.3 mmHg. (p less than 0.0001). Two patients developed mitral regurgitation greater than 2+/4 after the procedure. In none the residual left to right shunt was greater than 1.2L. There was no mortality. We conclude that in selected patients, excellent results are obtained PMTC with the Inoue balloon. Complications are minimal.

Adult↗
PubMedDate not supplied

[Diagnosis of tumor invasion of the cartilage in neoplasm of the larynx using computed tomography].

The demonstration of the tumoral invasion of the cartilaginous structure of the larynx is a fact that contraindicates any conservative treatment, either surgical or radiotherapeutic. The usual methods of clinical exploration, such as direct or indirect laryngoscopy or fiberoptic laryngoscopy are not very useful, as well as conventional radiology which presents little sensitivity to defect tumoral invasion. It has been communicated previously that computerised tomography (CT) is more sensitive. In our evaluation of these different diagnostic methods, we present a series of 51 patients with laryngeal cancer at different stages in a hom studies prior to surgery using computerised tomography (CT) have been realised. We evaluate the efficacy of his diagnostic method in the tumoral invasion of the laryngeal backbone. Results have been analysed, demonstrating that this method is superior to other techniques used.

Humans↗
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[Obstructive hypertrophic myocardiopathy and coronary atherosclerosis].

The purpose of this study was to determine the coexistence of idiopathic hypertrophic cardiomyopathy (IHC) and atheromatous coronary artery disease. We studied forty six patients with IHC documented by complete clinical study and also by left heart catheterization. The diagnosis was considered established, when the patient had a significant left intraventricular pressure gradient (LIPG) and by angiographic and or echocardiographic demonstration of systolic anterior movement of the mitral valve and asymmetric septal hypertrophy. In 15 patients a selective coronary angiography was performed because ischemic myocardial disease was suspected. There were eight patients with significant atherosclerotic obstruction (greater than 75% narrowing). There was one vessel disease in 13%, two vessels in 37% and three vessels in 50% of the patients. The LIPG was 43 +/- 20 mmHg, the left ventricular and diastolic pressure (LVEDP) was 18 +/- 11 mmHg in patients with atheromatous disease and there was no significant difference with the patients with normal coronary arteries with LIPG 52 +/- 31 mmHg and LVEDP 21 +/- 9 mmHg. Our data demonstrate that ischemic heart disease in patients with idiopathic hypertrophic cardiomyopathy is related not only to increase of the cardiac mass and/or the ventricular wall stress, but in some of them atherosclerosis plays a role in its pathogenesis. Significant differences were found between the aged in both groups. In the patients who had coronary atherosclerosis the mean age was 54 years; on the other hand in the patients with normal coronary arteries the mean age was 44 years. This last fact could explain the high frequency of atherosclerosis in the older patients.

Adolescent↗
PubMedDate not supplied

[Electro-vectorcardiographic aspects of diastolic and mixed overloads of the right ventricle].

We studied 400 cases of isolated atrial septal defect without severe pulmonary hypertension, in which the diagnosis was established by the hemodynamic data and it was proven by surgical findings in 257 instances. High fidelity unipolar thoracic and intracardiac records, as well as vectorcardiographic curves in three planes, were obtained. Different types of right ventricular conduction disturbances, which were present in all cases, as well as certain electro-vectorcardiographic aspects related to ventricular depolarization and repolarization, were analyzed. Mean angles of the resulting vectors at 60 msc of the ventricular activation, were determined relating to the types of block. The following points should be emphasized: Besides the right proximal blocks, which are more frequent, right distal ones can also be diagnosed by the presence of slurred R wave and delayed onset of the intrinsicoid deflection in only some right leads. The monofascicular and parietal right blocks are observed when the diastolic overload of the ipsilateral ventricle is low. The activation time of the anterior inferior right septal mass generally permits an objective classification of the degree of a right proximal block. The prolonged Q-Tc interval only in right leads, seems to be a function of the magnitude of the right ventricular diastolic overload.

Adolescent↗
PubMedDate not supplied

[Intravenous streptokinase in acute myocardial infarction. A Mexican multicentric study].

To evaluate the benefits of intravenous streptokinase (SQIV) in acute myocardial infarction (AMI), we joined a group of ten Mexican university hospitals, that were coordinated by the National Institute of Cardiology of Mexico. We included patients less than 70 years of age admitted to the hospital with less than 6 hours from the onset of chest pain during their first myocardial infarction. All patients had ST segment elevation of 1.5 mm or more, and none had contraindication for SQIV. They received 1.5 millions of SQIV in one hour. Reperfusion criteria included absence of pain, ST segment reduction and a rapid rise and fall of enzyme levels. Angiographic criterion for reperfusion was the permeability of the affected coronary vessel. Of 66 patients studied, 57 (86%) had clinical reperfusion; of the 24 available angiographic studies, 92% demonstrated reperfusion. Eight (12%) of the patients had minor complications and 7 (10%) had serious complications. There were 0 deaths. We concluded that SQIV is a useful therapeutic procedure, easy to perform in general hospitals.

Adult↗