Methadone-induced fibrous and calcified myopathy--a report of 2 cases.
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Calcinosis↗
Biomedical subjects
P Carpintero
Publications and source records attributed to P Carpintero.
Bilateral congenital dislocation of the patella.
We report the case of a six-year-old boy with Down syndrome who presented with flexion contractures of both knees and genu valgum. The diagnosis of bilateral congenital dislocation of the patella was established by clinical and xray examination. The patient was treated surgically with a satisfactory result.
Child↗
Bilateral luxatio erecta humeri.
The authors report one case of bilateral inferior dislocation of the shoulder, a rare form of injury, accounting for only 0.5% of all shoulder dislocations. Bilateral cases are even less frequent, with only six cases reported in the literature. The injury was complicated by paresia of the left axillary nerve and sensory alterations in both median nerves, without any associated osteoarticular or vascular injuries. The patients made a complete functional recovery within three years.
Adult↗
Significant increase in eradication rates of Helicobacter pylori infection with two consecutive dual therapies (omeprazole and amoxycillin or omeprazole and clarithromycin). A randomized study in 450 Spanish patients.
Helicobacter pylori infection is associated with peptic ulcer disease and chronic gastritis, and eradication of the microorganism markedly reduces the recurrence of peptic ulcer. However, a major problem is the choice of a treatment that is effective, has high eradication rate, and is well tolerated by patients. We evaluated the eradication of H. pylori infection in patients with chronic gastritis (CG), duodenal ulcer (DU), and gastric ulcer (GU) after two dual therapies (omeprazole with either amoxycillin or clarithromycin). Of 450 patients initially included in the study, 207 had CG, 187 DU and 56 GU, and all presented with H. pylori infection. Diagnosis was made from endoscope examination, biopsy samples, rapid urease test and 13C-urea breath test (UBT). H. pylori infection was considered to be present when two of the tests had positive results. All patients were randomized to one of two regimens: (A) omeprazole (20 mg b.i.d.) plus amoxycillin (750 mg t.i.d.) or (B) omeprazole (40 mg b.i.d.) plus clarithromycin (500 mg t.i.d.). The duration of each of the regimens was 2 weeks. Fifty-eight patients who showed H. pylori infection after the first treatment (27 with CG, 24 with DU, and 7 with GU) were allocated to a second therapy. H. pylori eradication was assessed by UBT, 6 weeks after the end of the therapies; positive values were those higher than 5 delta units. A second consecutive dual therapy of omeprazole plus an antibiotic (amoxycillin or clarithromycin) not used in the first therapy improved on the eradication rates obtained with the first regimen. The overall eradication rates were also higher, but no significant differences were found between amoxycillin and clarithromycin. The best results were obtained in those patients with GU.
Adult↗
[Chronic gastritis and Helicobacter pylori in patients with non-ulcerous dyspepsia. Role and significance of age].
Patients with recurrent upper abdominal complaints and without peptic ulcer or definite evidence of organic disease have been labelled as suffering from nonulcer dyspepsia and included in the study. A total of 125 patients were studied and upper gastrointestinal endoscopy performed. Histology, urease rapid test and ELISA serology were done in order to detect Helicobacter pylori infection. Age groups were done. The most frequent endoscopic and histological finding was chronic gastritis in all age groups of patients. In patients under 30 years old, the highest rate of normal endoscopy was found. Chronic gastritis was associated with Helicobacter pylori infection in 89.8% of all patients. The highest rate of chronic gastritis non associated with Helicobacter pylori infection was found in the age group of patients younger than 30 years old. Other factors as biliary reflux, gastroduodenal dismotility, decreased pain tolerance or stress have been proposed to be the etiology of chronic gastritis in young patients.
Adolescent↗
[Usefulness of the breath test with urea-13C in the diagnosis of Helicobacter pylori infection].
BACKGROUND: Many diagnostic methods of variable diagnostic profitability are available to detect infection by Helicobacter pylori. The aim of this study was to evaluate the usefulness of the European method of the breath test with urea-13C and compare the results with common histologic methods, the rapid urease test and serology. METHODS: Thirty-six patients who attended the Endoscopy Unit for recurrent symptomatology of the upper digestive tract were included in the study. A patient was considered to present infection by Helicobacter pylori on positivity of 2 of the usual methods: histology, rapid urease test and serology. RESULTS: The breath test with urea-13C was positive in 25 patients (13CO2 > 5 per 1,000) and negative in 10 patients with 100% specificity and 96% sensitivity. The specificity of the rapid urease test, histology and serologic tests were 90, 90 and 80%, respectively with 92, 88, and 88% sensitivity, respectively. CONCLUSIONS: The European method of the breath test with urea-13C is simple, non invasive and achieves the greatest profitability in the determination of Helicobacter pylori.
Adolescent↗
The relationship between pes cavus and idiopathic scoliosis.
STUDY DESIGN: The incidence of pes cavus and scoliosis was studied in three groups of patients. Group A contained 130 patients with idiopathic scoliosis, Group C contained 210 patients with idiopathic pes cavus, and Group B (control) contained 200 patients of similar age. OBJECTIVES: To investigate the joint presentation of pes cavus and idiopathic scoliosis, because both deformities may share a common etiology linked to muscle imbalance. SUMMARY OF BACKGROUND DATA: Sixty five percent of Group A patients (85 of 130) had an abnormally high plantar arch, compared to only 9.5% (19 of 200) of Group B control subjects. Nine percent (20 of 210) of the patients in Group C had scoliosis curves, compared to only four patients in Group B. METHODS: Radiographs were taken to determine the type of scoliosis curve, its location, and its magnitude, and to identify the incidence of spina bifida occulta in the three groups. The incidence and degree of pes cavus were established by means of foot prints. Statistical analyses were performed on all results. RESULTS: A statistically significant relationship (P < 0.01) was found for the incidence of pes cavus between Group A (scoliosis) and Group B (control), and for the incidence of scoliosis between Group C (pes cavus) and Group B (control). No statistical significance was observed for the other relationships investigated (sex, curve location, magnitude, spina bifida). CONCLUSIONS: There was a significant correlation between scoliosis and pes cavus--spina bifida was not an etiologic factor. Therefore, in certain patients where scoliosis and pes cavus present jointly, deformity may be secondary to altered balance or to disorders of the central nervous system.
Adolescent↗
Delayed diagnosis of fatigue fractures in the elderly.
A retrospective study was made of 30 stress fractures in elderly patients engaged in noncompetitive sporting activities, mostly marching and running. Fractures were located exclusively in the lower limbs. In many cases the diagnosis was delayed and in several cases was incorrect because the stress fracture was mistaken for other conditions. Given that the number of senior citizens engaged in active life and sporting activities is constantly growing, physicians should be aware of this type to ensure early diagnosis and appropriate treatment.
Age of Onset↗