Biomedical subjects

O Castillo

Publications and source records attributed to O Castillo.

At least 37 records · Page 2Linked to original sources

PubMed1999

[Laparoscopic adrenalectomy. Initial results of a Chilean experience].

BACKGROUND: Laparoscopic adrenal approach was introduced in 1992 and is becoming the surgical method of choice for several adrenal diseases. AIM: To report the initial Chilean experience in laparoscopic adrenalectomy. MATERIAL AND METHODS: A retrospective review of 17 patients subjected to the surgical procedure by the authors. RESULTS: The preoperative diagnosis were adenomas (8 patients), pheochromocytoma (3), cystic lesions (2), adrenal metastases (2), hyperaldosteronism (1) and a pituitary Cushing (1). The average lesion size was 5.4 cm, the operative time 2.5 hours and the hospital stay 2.5 days. Eight patients were discharged in less than 48 hours. Pain was managed with non steroidal antiinflammatory drugs in 14 patients. One subject required conversion to open surgery. Transfusions were required in complex cases with a diaphragmatic hamartoma, Cushing disease and in a combined adrenal and renal resection. One patient had to be re admitted due to a pancreatic pseudo cyst that was drained percutaneously. There have been no recurrences after a mean follow up of 2 years. CONCLUSIONS: This early experience with laparoscopic adrenalectomy shows good results. A good patient selection and experience with advanced laparoscopic surgery are requisites for a successful use of this surgical technique.

Adolescent↗

PubMed1999

[Detection of beta thalassemia by the technique of refractory amplification of mutation systems (ARMS-PCR)].

beta Thalassemia (Thal) mutations were studied in DNA from 80/159 patients with hemolytic anemia and high levels of Hb A2 by the amplification refractory mutation system technique (ARMS-PCR). This method detects point mutations and insertions or deletions of just a few nucleotides in the beta globin gene by the polymerase chain reaction of allele-specific priming. In 43/80 patients with different clinical presentations of beta Thalassemia and 37/80 compound heterozygous for hemoglobinopathies and beta Thalassemia the most frequent mutation found was the -29 (of African origin), followed by the CD39 (of Mediterranean origin) and in a lower frequency also was found the -88, the IVSI-6 and the IVSI-110. We conclude that this technique is an useful approach in determining the beta thalassemia mutations in population surveys, because it allows to make a differential diagnosis between beta Thalassemia minor and individuals with high levels of Hb A2. It helps to clarify the diagnosis of patients with structural hemoglobinopathies that also presents high levels of Hb A2.

Base Sequence↗

PubMed1999

[Hemorrhagic tuberous sclerosis. Report of a Jehovah Witness patient].

We report a 26 years old male with a tuberous sclerosis with multiple and bilateral kidney cysts and angiomyolipomas. The patient presented to the emergency room with a severe abdominal pain and anemia, secondary to a bleeding angiomyolipoma. The patient rejected blood transfusions due to his religious beliefs. A selective angiography was performed confirming diagnosis and the lesion artery was selectively embolized, stopping the bleeding immediately. The patient had a satisfactory evolution thereafter. This is a rare lesion and the fact that the patient was a Jehovah witness that rejected blood transfusions, required an innovative medical approach.

Adult↗

PubMed1997

Distribution of capsular types and antimicrobial susceptibility of invasive isolates of Streptococcus pneumoniae in Colombian children. Pneumococcal Study Group in Colombia.

Streptococcus pneumoniae is the leading bacterial cause of childhood pneumonia in the developing world. This study describes the type distribution and antimicrobial susceptibility of invasive pneumococcal isolates from Colombian children and is part of the Sistema Regional de Vacunas (SIREVA), a PAHO regional initiative designed to determine the ideal serotype composition of a protein polysaccharide pneumococcal conjugate vaccine for use in children less than 5 years old in Latin America. In Colombia, during the study period, centres in Bogota, Medellin, and Cali collected 324 S. pneumoniae isolates from invasive diseases, 238 (73.5%) from children under the age of 2. Pneumonia was the clinical diagnosis in 41.3% cases, meningitis in 41%, and sepsis in 11.2%. The seven most frequent types included 14(21.9%), 5(10.5%), 23F(9.6%), 1(9%), 6B(9%), 19F(7.1%), and 6A(6.2%). The frequency of diminished susceptibility to penicillin (DSP) was 12%, with 8.9% of isolates showing intermediate level resistance and 3.1% showing high level resistance. Among DSP isolates, 23% were also resistant to cefotaxime, 33.3% to erythromycin, 48.7% to chloramphenicol, and 74.3% to trimethoprim/sulfamethoxazole. Multiple resistance was detected in 59% of the isolates that have DSP. Penicillin resistance was associated with types 23F (53.8%) and 14 (25.6%). These data provides information on capsular types prevalent in Colombia that will not only allow the formulation of an ideal vaccine for the region but also reinforce the need for ongoing regional surveillance.

Anti-Bacterial Agents↗

PubMed1996

Assessment and accreditation of Mexican medical schools.

With the objective of evaluating and accrediting the quality of medical education in the country, the Mexican Association of Medical Schools initiated the National Programme for the Strengthening of the Quality of Medical Education (PNFCE). This programme led to the establishment of the National System of Accreditation. Medical school deans in Mexico determined the criteria for the evaluation of quality and its subsequent standards through a consensus process. The following 10 criteria resulted: general basis and educational objectives; government and institutional orientation; educational programme and academic structure; educational process assessment; students; teaching staff; institutional coherence; resources; clinical sites; and administration. Eighty-eight standards were developed in the instrument designed for the self-evaluation phase. The information resulting from the self-evaluation will be verified by a group of experts during a survey visit, which will be finalized with a report to serve as the basis for the decision to be made by the Accreditation Commission. The self-evaluation phase started in 1994. In 1996 four schools submitted their request for accreditation. As of July 1996, one survey visit has been completed and three more are programmed for the second half of the year.

Accreditation↗

PubMed1996

[Neodymium YAG laser in treating prostatic adenoma].

BACKGROUND: Conventional surgery and transurethral ablation are the treatments of choice for benign prostatic hyperplasia. AIM: To report our experience with Neodynium: YAG laser ablation of prostatic adenomas. PATIENTS AND METHODS: Revision of 182 patients subjected to Laser ablation of benign prostatic adenoma of whom 28 had a complete urinary retention and 50 were considered of high surgical risk. RESULTS: One hundred eighty patients had spontaneous voiding after surgery, there were no intraoperatory complications and were discharged 6 to 24 hours after the procedure. Urinary flow increased from 8 ml/sec in the preoperative period to 20 and 21 ml/sec, two and six months after surgery. Symptom score decreased from 12 to 1.2 points. Seven patients had late hematuria and two required vesical lavage and cystoscopic clot drainage. Ten patients had a positive urine culture. 12 had lack of ejaculation and 75%, had some degree of dysuria. CONCLUSIONS: Neodynium YAG laser ablation of benign prostatic adenoma seems to be efficient and safe.

Adult↗

PubMed1994

[Microwave transurethral thermotherapy in the treatment of prostatic adenoma].

We report 195 patients with prostatic adenoma treated with microwave transurethral thermotherapy. All patients were initially subjected to a clinical assessment including Madsen-Iversen symptom score, digital rectal examination, measurement of urine flow rate and residual urine volume, transrectal prostatic ultrasound examination and blood prostate specific antigen determination. A prostatron machine was used, installing an urethral probe under local anesthesia. Endourethral and rectal temperatures were simultaneously measured and the procedure was controlled by a special software. The treatment was performed in an outpatient basis with a single procedures that lasted 60 min. Of 31 patients with chronic urinary retention, 28 were left voiding spontaneously, without urethral catheters and 84% of 164 symptomatic patients were relieved. No complications occurred, although 31.1% of patients has a transitory urinary retention after the procedure. It is concluded that microwave thermotherapy is a good therapeutic alternative for prostatic adenoma.

Aged↗

PubMed1994

[Laparoscopic lumboaortic retroperitoneal lymphadenectomy in testicular neoplasm].

Lumboaortic lymphadenectomy is a therapeutic alternative for patients with nonseminomatous testis tumors and its principal untoward effect is the loss of ejaculation. The anatomic knowledge of lymph node metastasis allows lower limit definition of aortic dissection, maintaining the diagnostic sensitivity and ejaculation. We report three patients with nonseminomatous testis tumors subjected to a reduced video-laparoscopic lumboaortic lymphadenectomy. An adequate amount of tissue was obtained in all and lymph node metastasis found in two. No complications occurred and patients were discharged 48 hours later. It is concluded that this technique is an alternative staging technique with low morbidity that allows a rapid patient discharge.

Adult↗

PubMed1994

[Experience with the use of stomach in bladder reconstruction].

Bladder reconstruction with a gastric portion, as an alternative to other intestinal segments, has gained popularity lately. We have used a vascularized gastric segment for bladder replacement in 20 patients aged 3 to 77 years old, between 1990 and 1993. The surgical indication was due to a severe radiation cystitis in 11 cases, neurogenic bladder in 4, urinary diversion in 4 and cystectomy due to bladder cancer in 2. In 18 cases, associated surgical procedures were performed. Mild complications occurred in 3 cases and no patient died. Postoperative evolution has been excellent. Sixteen patients maintained a normal miction and 4 required self performed urethral intubation. It is concluded that stomach is a good alternative for bladder reconstruction. We are employing it with higher frequency in our practice due to the technical simplicity and the physiological advantages of its use. The metabolic acidosis secondary to ionic absorption that occurs with the use of other intestinal segments, specially in patients with renal failure, is avoided. Also, it facilitates surgical procedures in patients with severe abdominal radiation damage.

Adolescent↗

PubMed1993

[Extracorporeal lithotripsy by shock waves: results in 185 patients].

Extracorporeal shock wave lithotripsy has become the treatment of choice of nephrolithiasis with surgical indication. Our unit is managing urinary tract stones using the Sonolith 3000 lithotritor since April 1991. The procedure is performed in ambulatory patients and requires analgesia and mild sedation. We report the experience in the treatment of the first 185 patients. In 87% of them, the stones disappeared completely, 8.7% of patients were left with residual fragments without indication of further treatments and in 4.3% the procedure failed. There was no mortality. In 13 occasions, obstructive complications at the distal ureter were produced by the stone fragments that required ureteroscopy in only three patients and 11 patients had severe renal colic. We conclude that this procedure is safe and effective in the treatment of urinary tract stones.

Adolescent↗

PubMed1993

[Laparoscopic nephrectomy: report of 2 cases].

Laparoscopic surgery has become very popular in general surgery. Its most significant advantages for patients are a better postoperative comfort and fast return to work. We report two young female patients with a gynecologic cancer in whom a laparoscopic nephrectomy was performed. The surgical procedure and the post operative recovery were uneventful. These promising results show that laparoscopic surgery is applicable in traditional urologic procedures.

Adult↗

PubMed1992

Cholinergic receptors in the human vas deferens.

This study represents the first investigation demonstrating the contractile response to exogenous acetylcholine (ACh) in the isolated human vas deferens. Pharmacological characterization of cholinergic receptors was achieved using selective antagonists to define receptor subtypes. In the HVD the effect of exogenous ACh is revealed as a dose-dependent sudden increase in the basal tension of the vasa. The ACh receptors of the HVD were competitively antagonized by atropine (ATR) with a high pA2 value (8.78). The main finding of this study is the presence of cholinergic receptors of the pharmacologically defined M1-ACh subtype in the isolated HVD, according to the pA2 values obtained with pirenzepine (PRZ) 7.39, AF-DX 116 (AF) 5.92 and 4-DAMP 5.65, M1-ACh, M2-ACh and M3-ACh selective antagonists, respectively. Prazosin (PZ), a selective alpha 1-adrenergic antagonist, displayed a similar competitive antagonism for the contractile response evoked both by ACh (pA2 = 8.69) and NE (pA2 = 8.58) in the HVD. The antagonism exerted by PZ on the ACh-induced contractile response of the HVD, suggests that ACh probably acts at a presynaptic level stimulating the release of NE from an adrenergic neuron. According to these findings, the receptor involved in this action, located in the proximity of the nerve terminals, seems to be of the M1-ACh subtype.

Acetylcholine↗

PubMed1992

[Transurethral thermotherapy in prostatic adenoma].

Microwave thermotherapy is considered to be an alternative to conventional surgical treatment of benign prostatic hyperplasia (BPH). Our initial experience of the first six months shows this technique has achieved objective improvement of the symptoms and uroflowmetry, as well as a significant reduction of postmicturition residual urine. It carries a minimal morbidity, no mortality and has permitted recovery of micturition in over 90% of the patients with urinary retention.

Aged↗

PubMed1992

[Current diagnosis of renal cancer: clinical experience with 71 cases].

The diagnosis of renal cell carcinoma was frequently delayed due to the anatomic location of kidneys. Recently, the development of echographic imaging techniques has drastically changed this situation. In this retrospective review of 71 patients with renal cell carcinoma, the diagnosis was made incidentally during a routine abdominal ultrasound examination in 49% of cases. These patients, has lower stage and smaller tumors than symptomatic patients. Among the latter, hematuria was the principal presenting symptom. The early diagnosis of renal cell carcinoma allows more conservative surgical procedures and has a favorable effect on long term survival.

Adult↗

PubMed1992

[Renal oncocytoma: 4 cases].

Oncocytomas are tumors characterized by cells with an eosinophilic cytoplasm. Renal oncocytomas were described in 1942. Among 46 consecutive patients operated on for renal tumors, oncocytomas were found in 4 (8.7%). In spite of a supposedly benign nature, renal oncocytoma cannot be adequately differentiated from renal adenocarcinoma by imaging techniques. Therefore, we recommend radical surgery as the treatment of choice in these patients.

Adenoma, Oxyphilic↗

PubMed1990

[Hemoglobin variants and hematologic and serologic parameters of the population of El Limón (Aragua State, Venezuela)].

Nine hundred and fifty seven individuals from El Limon (Aragua State, Venezuela) were studied, in order to get information on their hematologic, immunologic and biochemical characteristics. The majority of surnames were of Spanish origin although there were also from other European nationalities. No surname from Venezuelan Indians was found. The pathologic hemoglobin variants (Hb S, Hb C and Hb D-Punjab) have a frequency of 4.3%. Eight albumin variants were detected. The hematologic values suggest a high frequency of iron deficiency. Positivity for hepatitis virus B was found in 0.9% of the population. The carriers and patients for hemoglobin variants per generation was calculated for the whole municipality (5062 and 26, respectively). The African component of the population was estimated in around 18%.

Adolescent↗

PubMed1990

[Epidermoid cyst of the testis. Report of 2 cases].

We report 2 patients with epidermoid cyst of the testis. Clinical, histological and echographic aspects are discussed. A radical orchyectomy was performed in one patient, a partial one in the other. A successful outcome followed in each case.

Adolescent↗

PubMed1990

[Rigid ureteroscopy: the indications and results in 154 patients].

We analyzed the indications and results of rigid ureteroscopy performed in 154 consecutive patients. Treatment of ureteral lithiasis was the main indication. Success rate for this procedure was 95.4%. Evaluation of hematuria and treatment of ureteral stenosis constituted most of the remaining indications for the procedure.

Adolescent↗