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Biomedical subjects

M Martínez Ruiz

Publications and source records attributed to M Martínez Ruiz.

15 recordsLinked to original sources

[Incidence and clinical characteristics of Kawasaki's disease].

OBJECTIVE: The aim of this study was to analyze the incidence and clinical spectrum of Kawasaki's disease in children attended in our hospital. PATIENTS AND METHODS: Retrospective review of all children with Kawasaki's disease evaluated in the Department of Infectious Diseases of Hospital La Paz (Madrid, Spain) from January 1999 to June 2002. Information included clinical manifestations, age, sex, seasonal occurrence, treatment, development of cardiovascular abnormalities, and incidence rate. RESULTS: Forty-five patients with Kawasaki's disease were analyzed during the study period. Age ranged between 4 months and 13 years. Thirty-seven children were aged 5 years old or less and 15 children were younger than 2 years. The most common symptom was fever in 98 % of the patients. Five patients developed coronary aneurysms. Of these, four were aged less than 2 years and three were treated after the first week of onset of fever. The annual incidence rate in our health area was estimated at 15.1 cases per 100,000 children aged 5 years or less. CONCLUSIONS: The annual incidence rate for Kawasaki's disease in our area was similar to that in Europe and the United States. Coronary aneurysms were more common in children aged less than 2 years and in patients who received treatment after 1 week of the onset of fever.

Adolescent↗

[Diagnosis, treatment and long-term outcome in Cushing's disease].

Cushing's disease is uncommon in childhood. It is usually caused by the oversecretion of adrenocorticotrophic hormone (ACTH) by a pituitary corticotroph adenoma. Clinical abnormality is often undetected for long periods of time. The principal clinical features are growth retardation and obesity. We present four patients who were diagnosed with Cushing's disease in a tertiary hospital from January 1995 to December 2002. There were two boys and two girls, aged 10-15 years. The main clinical features at presentation were growth failure and excessive weight gain. The interval between onset of symptoms and diagnosis ranged from 2.5 to 5 years. All patients presented moon face and increased fat around the neck. In all patients, 24-hour urinary free cortisol was high and loss of normal serum cortisol circadian rhythm (3/3) and suppression of cortisol to less than 50 % of the basal level with high-dose but not with low-dose dexamethasone (2/2) were observed. Pituitary microadenoma was detected by magnetic resonance imaging in three patients; no tumor was detected in the fourth patient and inferior petrosal sinus sampling was performed, showing left lateralization of ACTH central secretion. Therapy consisted of transsphenoidal surgery in all patients. Two patients are in remission, one patient presented disease recurrence requiring total hypophysectomy because the tumor could not be completely removed and one patient had persistent disease after a second intervention and required pituitary radiotherapy. Two patients showed pituitary hormone deficiency after therapy.

Adenoma↗

[Usefulness of carbohydrate-deficient transferrin in alcohol-elated problems].

BACKGROUND: Carbohydrate-Deficient Transferrin (CDT) is a new marker for excessive alcohol drinking. It appears to be useful to detect alcoholism, harmful consumption and relapse. It have been introduced in our country recently. METHOD: Recent studies about utility of CDT have been reviewed. RESULTS: Sensitivity and specificity of CDT level as a marker of alcoholism were 72-97% and 31-81% respectively. As a marker of harmful consumption its sensitivity was 15-69% and its sensitivity was higher than 82%. CDT was demonstrated to be a effective maker for evaluating alcoholic abstinence in alcoholic patients. CONCLUSIONS: CDT determinations have a high specificity for screening heavy drinking in different settings. Problems related to its sensitivity are discussed.

Alcohol-Related Disorders↗

Intravenous magnesium load test in elderly patients with protein-energy malnutrition.

Forty-two elderly patients were subjected to a nutritional assessment and an intravenous magnesium load (0.5 mmol/kg). After 48 h, patients with protein-calorie malnutrition (PCM) showed magnesium retentions (MgR) above 20 per cent, thus indicating magnesium deficit, and greater (P < 0.001) than those from well-nourished patients. The discriminating cross-point for undernourished patients was at 28 per cent with 95 per cent sensibility and specificity. There were significant correlations between MgR and most nutritional parameters. An increase of the RMg constitutes a PCM indicator which may be useful to quantify it.

Aged↗

[Neck pyomyositis associated with polymicrobial sepsis of sinusal origin].

Spontaneous pyomyositis (primary pyomyositis) is an infrequent disease in non-tropical countries, caused by bacterial infection of skeletal muscle. Although pyomyositis is associated in many cases to septicemia, the occurrence of that disease as a secondary manifestation of bacteremia is very unusual, requiring a high-grade index of suspicion to diagnose it in the early stages. We present one case of cervical pyomyositis, caused by Fusobacterium necrophorum and group F streptococcus, during the course of a sepsis of sinusal origin, that was treated without surgical therapy. This so uncommon form of presentation of Fusobacterium septicemia, its diagnosis and treatment are discussed.

Adult↗

[Multiple paraganglioma].

Paragangliomas are tumors of the chromaffin system producing catecholamines and both the adrenal extra-adrenal type have a common origin at the neural crest, which has been supported by the similarities of the paraganglions both from a histological and functional perspective. Most of the extra-adrenal paragangliomas are bending and non-functional. In addition, they are usually confined to just one site. We present the case of a young patient with benign multiple paraglanglioma in two different locations, juxtahepatic and juxtacarotic (Chemodectoma) and, thus, far away from each other. The extra-abdominal location is very rare, with a frequency lower than 2%. In addition, one of paraganglions was functional and the other one was not. Initially, a surgical intervention was performed on the functional abdominal tumoration and latter, another intervention was performed at the cervical level, both with excellent results. We also highlight the good response to the postoperative therapy with Prazosin.

Abdominal Neoplasms↗

[Conservative treatment in spontaneous splenic rupture due to infectious mononucleosis].

Spontaneous rupture of the spleen secondary to infectious mononucleosis frequently proves to be an urgent surgical decision: splenectomy during a exploratory laparotomy. Few cases have been described where diagnosis was made by means of an abdominal ultrasound and those followed-up and treated conservatively, are most exceptional. A case of rupture of spleen during a course of an infectious mononucleosis, confirmed by abdominal ultrasounds and treated conservatively, with good evolution, is presented.

Adolescent↗

[Tuberculous infection in Sagunto: infection indicators and study of tuberculin-positive children contacts].

After having ascertained their relevance, epidemiologic indicators of tuberculosis infection were calculated in the area of coverage of a district hospital. For this purpose, a tuberculinic survey was undertaken among students of 2nd. and 8th. grade (EGB) and among those of 1st. grade during two consecutive courses. A prevalence of 2.08% (+/- 1.08%) in 1st. grade (in 1986-87), of 1.18% (+/- 0.87%) in 1st. grade (in 1987-88), of 1.13% (+/- 0.79%) in 2nd. grade (in 1987-88) and of 2.19% (+/- 1.10%) in 8th grade (in 1987-88). The annual incidence of infection in the studied period was 0. The Annual Risk of Infection (ARI) was lower than 0.12% with an annual reduction of 57%. This is the first time that indicators of infection are obtained in a population of the region of Valencia, and are compared with other populations. We outline the benefits of the investigation of the source of infection and of the family contacts. Fourty-eight Mantoux (+) children were detected, of which 8 had tuberculosis, 1 had residual lesions, and the remaining ones were at the infectious stage. Among the 105 studied adults, 60 were Mantoux (+), of which 6 had tuberculosis, 2 of them were smear (+) and 5 had residual lesions. Chemoprophylaxis was initiated in 14 cases.

Child↗