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Biomedical subjects

P Fernandez-Segoviano

Publications and source records attributed to P Fernandez-Segoviano.

6 recordsLinked to original sources
PubMed2001

Fine-needle aspiration biopsy of liver masses: diagnostic value and reproducibility of cytological criteria.

There are many helpful cytological criteria for the diagnosis of liver fine-needle aspiration biopsies (FNABs), but none of them are pathognomonic of primary or metastatic tumors. We analyzed the diagnostic value and reproducibility of 28 cytological parameters in FNABs from 140 hepatic masses, including 29 benign lesions, 49 hepatocellular carcinomas (HCCs), and 62 metastatic tumors, encompassing 48 adenocarcinomas (ACAs). Five different observers evaluated each sample, and the interobserver and intraobserver agreement was studied. Multivariable analysis showed that the criteria more closely associated with malignancy were irregular nuclear contour, three-dimensional cell groups, and atypical naked nuclei. Capillaries separating tumor cells and granular cytoplasm were strongly associated with HCCs, while eccentrically placed nuclei and necrosis were most commonly seen in ACAs and in metastatic tumors. The intraobserver and interobserver agreement was excellent for the final cytological diagnosis, and there was fair to very good interobserver agreement for 22 of the 28 criteria studied. Architectural features were less reproducible than pure cytological criteria. Intraobserver variability was not influenced by the years of experience in the field. A precise and strict definition of terminology rendered a better reproducibility of the cytological criteria.

Biopsy, Needle↗
PubMed1988

Autopsy as quality assurance in the intensive care unit.

A prospective study of 100 autopsies was carried out. The clinical and pathologic diagnoses were made independently by intensivists and pathologists; at the end of the study, the differences were determined. There were seven Class I errors (which if detected before death, would probably have led to a change in management that might have resulted in cure or prolonged survival), six of these relating to the basic disease and one to the cause of death. Class II errors occurred in 15 patients, ten relating to the basic disease and five to the cause of death. In 61% of the patients, the major and minor diagnoses coincided. In 77% of the patients, the major diagnoses coincided. No relationship was found between the incidence of Class I and Class II errors and the length of the patients' stay in the ICU.

Adolescent↗
PubMed1983

Radiographic findings for the adult respiratory distress syndrome in patients with peritonitis.

Ninety-seven consecutive patients admitted to the ICU with peritonitis were studied. Of these, 66 (68%) died and autopsies were performed on 38 (58%). Twelve of the 38 autopsied patients showed pathologic criteria of adult respiratory distress syndrome (ARDS); 26 did not. Chest x-rays of the 38 autopsied patients were examined and 9 (75%) of the 12 patients with histologic criteria of ARDS, specifically, moderate or severe fibrosis, had decreased pulmonary longitudinal diameter on serial chest x-rays. The remaining 3 (25%) patients did not have this specific finding. Of the 26 patients without pathologic criteria of ARDS, only 2 (8%) had reduction in pulmonary longitudinal diameter. We conclude that a marked reduction in the pulmonary longitudinal diameter is highly suggestive of ARDS and especially useful in differentiating ARDS from bilateral pneumonia.

Adult↗
PubMed1983

Endocarditis caused by B fragilis.

A 54-year-old man had had an acute anterior myocardial infarction nine years prior to this hospital admission. Since that time he had been asymptomatic with the exception of occasional episodes of precordial chest pain. The patient died from septic shock on the tenth day after the present admission. On autopsy there was an old myocardial infarct with aneurysmal dilatation of the left ventricle which contained a large thrombus with multiple abscesses. Septic infarcts were also found in the left kidney and the left temporal lobe of the brain.

Bacteroides Infections↗
PubMed1983

ARDS due to ingestion of denatured rapeseed oil.

Among the different etiologies of noncardiogenic acute pulmonary edema is found the administration or ingestion of various substances. We have studied two patients with ARDS secondary to the ingestion of toxic oil. Both patients presented similar roentgenographic findings characterized by interstitial and alveolar infiltration in "butterfly" distribution, pleural effusion, and a normal cardiac silhouette. The two cases also showed a pulmonary compliance either normal or slightly diminished. With the aid of artificial ventilation, they evolved favorably, gaseous exchange and chest x-ray films returning to normal 16 and 22 days after admission.

Adult↗