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P Bureo Dacal

Publications and source records attributed to P Bureo Dacal.

At least 19 recordsLinked to original sources
PubMed2003

[Diagnostic utility of D-dimer measurement in patients with clinical suspect of pulmonary thromboembolism in the setting of an Internal Medicine Department].

BACKGROUND: The diagnosis of pulmonary thromboembolism (PTE) may be a challenge in many cases, particularly among the elderly patients. OBJECTIVE: To establish the diagnostic utility of D-dimer measurement by a rapid semi-quantitative immunoassay (NycoCard, D-Dimer, normal value < or =0.3 mg/l) in a series of patients with suspected PTE admitted to an Internal Medicine Department. METHODS: Retrospective review of 48 patients admitted to our Department with the clinical suspect of PTE and D-dimer assay, in whom a lung ventilation/perfusion scan was conclusive (high or normal/very low/low probability of PTE). RESULTS: The median age of patients was 67.4 years and 79.2% were older than 60 years. For the diagnosis of PTE, the values of sensitivity, specificity, positive predictive value, and negative predictive value were 95.2%, 55.5%, 62.5% and 93.7%, respectively. When patients with potential confounding factors in the measurement of D-dimer (surgery and/or trauma in the 2 previous weeks, or neoplasm) were excluded, similar results were obtained. CONCLUSIONS: When a normal D-dimer (< or =0.3 mg/l) measurement by a rapid semi-quantitative immunoassay (NycoCard) is obtained, the presence of PTE is very unlikely. An increased D-dimer should lead to additional complementary tests to confirm or rule out PTE. These results apply for patients aged over 60 years and are not influenced by potential confounding factors.

Aged↗
PubMed2003

[Pulmonary thromboembolism in the elderly].

OBJECTIVE: To describe the characteristics of pulmonary thromboembolism (PTE) in the elderly and to identify potential differences between elderly and non-elderly patients. PATIENTS AND METHODS: Retrospective review of 154 consecutive patients diagnosed of PTE in an Internal Medicine service between January 1993 and December 2001. RESULTS: Ninety patients (58.4%) were older than 70 years. Prior cardiopulmonary disease was significantly more frequent in patients older than 70 years (41.1% vs 23.4%, p = 0.03). Deep venous thrombosis (DVT) clinic was significantly less frequent in older than 70 years (36.7% vs 53.1%, p = 0.04). The rest of studied characteristics was similar in both groups. Four patients older than 70 years (4.4%) did not have "classical" symptoms of PTE (dyspnea, centrothoracic pain, pleuritic pain and/or hemoptysis). Three patients older than 70 years (3.3%) did not have "classical" signs of PTE (tachypnea, tachycardia and/or crackles) nor DVT clinic. Three patients older than 70 years (3.3%) had a normal alveolar-arterial oxygen gradient. Hospital death was more frequent in older than 70 years, but without reaching statistical significance (8.9% vs 3.1%, p > 0.05). CONCLUSIONS: PTE characteristics are similar in elderly and in non-elderly patients, although DVT clinic is less frequent in elderly. The absence of "classical" symptoms of PTE, the absence of "classical" signs of PTE and DVT clinic, and a normal alveolar-arterial oxygen gradient are very infrequent in elderly with PTE. Hospital mortality in PTE may be higher in patients older than 70 years.

Adult↗
PubMed2002

[The current clinical spectrum of pulmonary thromboembolism].

BACKGROUND. Mortality in pulmonary thromboembolism (PTE) decreases considerable when it is diagnosed early. The suspicion based on clinical and complementary data is essential for an early diagnosis. METHODS. Retrospective review of the clinical features in patients diagnosed of PTE in an Internal Medicine department from January 1993 to December 1999. RESULTS. A total of 117 patients with PTE were identified. The median age was 68.8 years. Sixty-six patients (56.4%) had one or more risk factors for PTE. The most common risk factor was immobilization (37.6%). Dyspnea was the most common symptom (74.4%) and tachypnea the most common sign (66.7%). Fever/low grade fever and leukocytosis were present in 16.2% and 31.6% of patients, respectively. Respiratory failure, alkalosis and hypocapnia were present in 44.4%, 38.5% and 47% of patients, respectively. An alveolar-arterial oxygen gradient > 20 mmHg was demonstrated in 96.6% of patients. Chest radiographs and electrocardiograms were normal in 52.1% and 23.9% of patients, respectively. A vein echo-duplex of the lower limbs demonstrated deep vein thrombosis (DVT) in 52.1% of patients. The hospital mortality rate was 6.8%. CONCLUSIONS. PTE still affects older patients mainly and frequently known risk factors are not detected. The presence of fever/low grade fever and/or leukocytosis does not rule out PTE. Both chest radiographs and electrocardiograms may be normal. Not demonstrating DVT in the lower limbs by the vein echo-duplex does not rule out PTE. The hospital mortality rate has not decreased considerably in the last few years.

English Abstract↗
PubMed2002

[Antineutrophil cytoplasmic antibodies (ANCA): clinico-pathologic correlations iin a series of 82 cases].

OBJECTIVE: Antineutrophil cytoplasmic antibodies (ANCA) have been described in a great variety of diseases in addition to the ANCA-associated systemic vasculitis (Wegener's granulomatosis (WG), microscopic polyangiitis (MPA) and Churg-Strauss syndrome (CSS)) and the pauci-immune rapidly progressive glomerulonephritis (RPGN). The objective of this work is to describe the clinical-pathological diagnosis of a series of patients with ANCA. MATERIAL AND METHODS: Retrospective review of patients with positive ANCA by indirect immunofluorescence in our hospital between January 1997 and December 1998. RESULTS: We identify 82 patients with ANCA. Six cases (7.3%) showed a C-ANCA pattern, 19 (23.2%) a P-ANCA pattern and 57 (69.5%) an atypical pattern. Eight patients (9.7%) had an ANCA-associated systemic vasculitis (5 WG, 2 MPA and 1 SCS). Four patients (4.9%) had a pauci-immune RPGN without systemic vasculitis. One only case (1.2%) in our series presented a C-ANCA pattern without evidence of an ANCA-associated systemic vasculitis or a pauci-immune RPGN. CONCLUSIONS: The atypical pattern is the most frequent in patients with ANCA. A minority of patients with ANCA have an ANCA-associated systemic vasculitis (WG, MPA or SCS) or a pauci-immune RPGN. The occurrence of a C-ANCA pattern is exceptional in patients without an ANCA-associated systemic vasculitis or a pauci-immune RPGN.

Adult↗
PubMed2002

[Primary antiphospholipid syndrome: characteristics and course of a series of 17 cases].

BACKGROUND: Primary antiphospholipid syndrome (APS) is a thrombophilic disorder which is not associated with connective tissue diseases or with other diseases. METHOD: Retrospective review of patients diagnosed of primary APS in an Internal Medicine service between January 1996 and December 2000. RESULTS: We identified 17 patients with primary APS. The most common presenting manifestations were deep vein thrombosis (7 cases) and ischemic stroke (3 cases). Eleven patients (65%) had vein thrombosis, 4 (24%) arterial thrombosis and no patient had both types of thrombosis. The 15 patients with thrombosis received treatment with indefinite oral anticoagulation (INR between 2.5 and 3.5). There was no recurrence of thrombosis or major hemorrhagic complications after a median follow-up time of 36 months (range 10-52 months). CONCLUSIONS: The most common presenting manifestation of primary APS is deep vein thrombosis. Venous thrombosis is more frequent than arterial thrombosis. The occurrence of both types of thrombosis seems to be exceptional. Long-term oral anticoagulation is an effective and safe treatment to prevent the recurrence of thrombosis in patients with primary APS.

Adult↗
PubMed2001

[Evolution of antithrombin activity and plasma fibrinogen levels and of hematologic values among women in child-bearing age on treatment with the new hormonal oral contraceptives].

OBJECTIVE: To study the evolution of antithrombin (AT) and plasma fibrinogen levels and of hematologic values among women in child-bearing age on treatment with the new hormonal oral contraceptives (HOC): in microdose, ultramicrodose and Diane-35. METHOD: Retrospective review of 100 randomized cases out of a total registry of 1,245 clinical records. RESULTS: The mean age in our series was 23.4 years (range: 18-39 years). The mean study time was 3.3 years (range: 1-5 years). During the study period, there was not a single woman with an AT lower than 70%. There were no significant changes at the end of the study period regarding AT, plasma fibrinogen, hematocrit, hemoglobin, prothrombin activity and activated partial thromboplastin time. A significant decrease was observed for platelet count (246,113 5,842 vs. 215,636 4,383 platelets/mm3; p = 0.003). There was not a single case of thrombocytopenia registered. No relevant differences were observed between the treatment groups with microdosaged, ultramicrodosaged and Diane-35. CONCLUSIONS: At mid-term (3.3 years), the new HOC (in microdose, ultramicrodose and Diane-35), do not cause significant changes in AT, plasma fibrinogen, hematocrit, hemoglobin, prothrombin activity and activated partial thromboplastin time. In our series, a moderate but significant decrease in the platelet count was observed but there were no cases of thrombocytopenia. The effect of the different new HOC on the studied parameters was similar.

Adult↗
PubMed2001

Brucellar spondylitis and meningoencephalitis: a case report.

Brucellosis, a zoonosis with a worldwide distribution, is a systemic infection that can present with involvement of both nervous and musculoskeletal systems. We report a case of spondylitis and meningoencephalitis and describe the clinical features, and difficulties in treatment. Osteoarticular complications of brucellosis are common but involvement of the nervous system is rare and it should be included in the differential diagnosis of any obscure neurologic disorder.

Anorexia↗
PubMed2001

[Differences between tuberculous spondylitis and brucellar spondylitis].

OBJECTIVE: To identify potential differences in the clinical and laboratory characteristics between tuberculous spondylitis (TS) and brucellar spondylitis (BS). PATIENTS AND METHODS: Retrospective study of patients with TS and BS diagnosed in our hospital between january 1992 and december 1998. RESULTS: TS was diagnosed in 17 patients and BS in 10 patients. In our series, a higher delay in the diagnosis (27.9 +/- 24.6 vs. 16 +/- 5.6 weeks, p = 0.02) was found in TS. There was a higher frequency, but without stadistic significance, of immunosuppression, one or several paravertebral or epidural abscesses, spinal cord compression, anemia and an elevated erythrocyte sedimentation rate in TS, and a higher frequency of fever/febricule and residual vertebral pain in BS. Lumbar location was the most frequent in both groups (58.8% in TS and 70% in BS). CONCLUSIONS: It is possible that there were some differences in the clinical and laboratory characteristics between TS and BS which may be an aid in the differential diagnosis of both entities and orient the empirical treatment in these cases without a definitive microbiological diagnosis or while awaiting the diagnostic confirmation.

Adolescent↗
PubMed2000

[Giant-cell arteritis: a descriptive study in southwestern Spain].

OBJECTIVE: To study the clinical and laboratory features of a series of patients with giant cell arteritis (GCA) or temporal arteritis in south-western Spain (Extremadura). PATIENTS AND METHODS: Retrospective study of 25 patients with GCA diagnosed by temporal artery biopsy between 1990 and 1998. RESULTS: Nine patients were males and 16 (64%) females. Sixteen cases (64%) presented polymyalgia rheumatica (PMR). Other clinical findings were: fever/febricula (64%), constitutional syndrome (64%), new headache (96%), visual symptoms (48%), jaw claudication (17%) and abnormal temporal arteries (17%). All patients had an ESR of more than 50 mm/hour and a raised C-reactive protein. Thirteen patients (52%) had anemia (hemoglobin level < 12 g/dl). Eleven cases (44%) presented a platelet count higher than 400,000/mm3. Four patients (16%) had an elevated AST and/or ALT levels and 8 patients (32%) had an elevated GGT and/or alkaline phosphatase levels. In patients with PMR, there was a higher frequency of constitutional syndrome (81 vs 33%, p = 0.02). In females, there was a higher frequency of anemia (75 vs 11%, p < 0.01), platelet count higher than 400,000/mm3 (75 vs 0%, p < 0.01) and elevated AST and/or ALT (25 vs 0%, p < 0.01) and elevated GGT and/or alkaline phosphatase (50 vs 0%, p < 0.01) levels. CONCLUSIONS: The clinical and laboratory features of GCA in our series of patients in south-western Spain are similar to that described in other spanish populations, with the exception of a slightly higher frequency of PMR and a lower frequency of jaw claudication and abnormal temporal arteries. In our study, the clinical picture of GCA was more severe in patients with PMR and in females.

Aged↗
PubMed1995

[Bronchogenic cyst with atypical localization].

Bronchogenic congenital cysts are uncommon. They most frequently develop into the lung parenchyma. Rarely, mediastinal site may occur due to intestinal origin. Bronchogenic cysts seldom arise in the posterior mediastinum. Computerized tomography of the chest allowed a diagnosis of a posterior mediastinal bronchogenic cyst in our patient with poor symptoms. Cyst aspiration and MRI (magnetic resonance imaging) also provide the diagnosis. Treatment is by surgical excision if symptoms occur and have good prognosis.

Bronchogenic Cyst↗