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Biomedical subjects

M Granell

Publications and source records attributed to M Granell.

6 recordsLinked to original sources
PubMed2006

Frequency and risk factors for thrombosis in idiopathic myelofibrosis: analysis in a series of 155 patients from a single institution.

Thrombosis is a frequent complication of polycythemia vera and essential thrombocythemia, but its incidence and predisposing factors in idiopathic myelofibrosis (IM) are unknown. In 18 (11.6%) of 155 patients diagnosed with IM in a single institution, 31 thrombotic events (19 arterial, 12 venous) were registered after a mean follow-up of 4.2 (s.d.: 4.5) years. In six patients, the thrombosis was simultaneous to or appeared a few months before IM diagnosis and 14 had one or more thrombotic episodes. When compared with the general population, a significant increase was observed in the incidence of venous thrombosis (odds ratio 17.5, 95% confidence interval: 10.3-31.4). At multivariate analysis, the initial variables associated with an increased risk of thrombosis were thrombocytosis (platelets >450 x 10(9)/l, P=0.001), presence of one cardiovascular risk factor (arterial hypertension, smoking, hypercholesterolemia, or diabetes, P=0.003), cellular phase of myelofibrosis (P=0.005), and Hb >11 g/dl (P=0.02). Considering post-diagnosis events, the 5-year thrombosis-free survival probability was 90.4% in the series, 80.6% for patients with platelets >450 x 10(9)/l, 82.6% for patients with one cardiovascular risk factor, and 85.1% for those in cellular phase. These results indicate an increased thrombotic risk for IM patients with hyperproliferative features and/or coexistent cardiovascular risk factors.

Adolescent↗
PubMed2001

[Anesthesia for carotid paraganglioma exeresis. Report of 3 cases].

This report of carotid paraganglioma excision in three patients discusses differential diagnosis, preoperative assessment, preoperative embolization of the tumor, monitoring of anesthesia including cerebral oximetry, and postoperative complications. We consider cerebral protection to be essential during carotid paraganglioma surgery. Such protection may be provided by drugs such as sodium thiopental and by temporarily shunting the internal carotid artery. Preoperative angiography is also important for evaluating retrograde circulation through Willis's polygon and to examine the arteries irrigating the tumor. Information thus obtained helps establish the need for presurgical embolization of the tumor, thereby possibly reducing the risks, such as obstructive hematoma that are inherent to the procedure. Finally, in our opinion, full monitoring should include cerebral oximetry so that possible complications can be detected and resolved.

Adult↗
PubMed1998

[Our experience with the Univent tube].

INTRODUCTION: We describe our experience in managing single lung ventilation (SLP) with the Univent bronchial blocker tube from 1993 to the present. PATIENTS AND METHOD: Patients were grouped based on the following criteria: use of a double lumen tube as an alternative to SLP (group 1), use of SLP and tracheotomy (group 2), or difficult or dangerous orotracheal intubation (group 3). RESULTS: The mean age of the 32 patients (22 men and 10 women) studied was 45.7 +/- 12.2 years. Mean weight was 67.9 +/- 13.4 kg. Ten patients were physical status ASA I, 10 were ASA II, 10 were ASA III and 2 were ASA IV. Group 1 contained 28 patients (18 receiving right SLP and 10 receiving left SLP; use of SLP failed to collapse the lung in 4 patients [14.3%]). Group 2 consisted of 5 patients and group 3 contained 11. The Univent tube was used in 4 patients in group 3 who did not require use of SLP but whose intubation was considered difficult and in whom laryngoscopic findings were consistent with a Cormack-Lehane group III classification. The Univent bronchial blocker tube was used as a guide, such that intubation was achieved on the first try. The tube was removed from 3 patients (8%) in the intensive care recovery ward. The remaining 29 tracheas were extubated in the operating room. No side effects attributable to the Univent tube were recorded. CONCLUSIONS: The advantages and disadvantages of this new tool for the management of SLP mean that it may be useful for specific situations (such as for SLP with difficult intubation or in patients with tracheotomies or aneurysms of the descending thoracic aorta), but that it does not replace conventional methods. We believe that the Univent bronchial blocker tube should be available as part of operating room equipment.

Adult↗
PubMed1997

[Ehlers-Danlos syndrome type III and pregnancy: labor analgesia].

We report the use of obstetrical extradural analgesia in a primigravida with Ehlers-Danlos syndrome type III. Management focused on the possible vascular tissue involvement and the risk of bleeding during the access into the extradural space. The procedure was performed after ruling out the anomalies in the dermis and its vasculature.

Adult↗