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Pedro Redondo

Publications and source records attributed to Pedro Redondo.

18 recordsLinked to original sources
PubMed2006

New techniques for the evaluation and therapeutic planning of patients with Klippel-Trénaunay syndrome.

BACKGROUND: Klippel-Trénaunay syndrome (KTS) is a well-known eponym for a capillary-lymphatic-venous malformation which is associated with soft tissue and skeletal hypertrophy, usually of one or more limbs. Plain films, sonograms, conventional venograms, and arteriograms have been employed for the evaluation of the disease. OBJECTIVE: To demonstrate the usefulness of multidetector computed tomography (MDCT) and fast 3-dimensional magnetic resonance imaging (3D-MR) venography for the assessment and therapeutic planning of patients with KTS. METHODS: A prospective study in 16 consecutive patients with KTS using MDCT and 3D-MR venography, performed between January 2004 and January 2006 in a university hospital in Pamplona, Spain. RESULTS: In nearly all patients, persistent embryologic veins were observed, and in one subject aplasia/atresia of the whole deep venous system of the affected extremity was seen. In four individuals hypoplasia of the femoral vein was observed; one subject had duplication of the femoral vein, and in three patients aplasia/atresia of this vein was found. Only half of the patients had normal popliteal veins. In one patient, aneurysmal dilatation of the popliteal vein was detected, and in six subjects, aplasia of this vein was observed. The presence of geographic stains was suggestive of hypoplasia and/or aplasia of femoral and popliteal veins. LIMITATIONS: The small size of the group of patients with KTS, which is related to low incidence of the disease. CONCLUSIONS: MDCT and 3D-MR venography are extremely helpful for the global evaluation of patients with KTS. Information regarding soft tissue and bony anatomy as well as information about superficial and deep venous systems may be obtained with a single exam.

Adolescent↗
PubMed2006

[Update in the treatment of herpes zoster].

The systemic treatment of herpes zoster shortens the healing process, and prevents or alleviates pain and other acute or chronic complications, especially when it is administered in the first 72 hours after symptoms appear. This treatment is especially indicated in patients over the age of 50 and in those who, regardless of age, have head and neck involvement, especially in herpes zoster ophthalmicus. The drugs approved in Europe for the systemic treatment of herpes zoster are aciclovir, valaciclovir, famciclovir and brivudine. Brivudine shows greater effectiveness against the varicella-zoster virus than aciclovir and its derivatives, and can be given just once a day for seven days, compared to multiple doses of the latter. As opposed to the others, brivudine is a non-nephrotoxic drug that should not be administered to immunodepressed patients or to those being treated with 5-fluorouracil. The treatment of herpes zoster to reduce pain should be combined with analgesics and neuroactive agents (amitriptyline, gabapentin, etc). While corticosteroids are of dubious efficacy in the treatment of post-herpes neuralgia, the intensity and duration of the pain can be reduced with some topical treatments (capsaicin, lidocaine patches, etc). Finally, this review discusses treatment guidelines for special locations (cranial nerves) and different subpopulations (children, pregnant women, immunodepressed patients, etc).

Administration, Oral↗
PubMed2006

Repair of large defects in the forehead using a median forehead rotation flap and advancement lateral U-shaped flap.

BACKGROUND: The forehead is a large and highly expressive and dynamic cosmetic unit. Most forehead defects that cannot be closed primarily are reconstructed with laterally based advancement flaps. OBJECTIVE: A combination of median forehead rotation flap and advancement lateral U-shaped flap for repair of medium- to-large-size defects in paramedian and lateral forehead is described. METHODS: Technically, the design of median forehead rotation flap based on supratrochlear vessels used here is similar to the median forehead transposition flap used to reconstruct large defects of the nasal dorsum. The length and the movement of the flap are much smaller in this case. Approximately 2/3 of the closure of the defect is achieved by displacing the median forehead flap while the remaining 1/3 corresponds to the advancement of the lateral U-shaped flap. RESULTS: The flaps are simple to perform, have minimal complications, and have good cosmetic results. A representative case is presented with photographs. CONCLUSION: For selected medium- to large-size horizontal defects in the paramedian and the lateral forehead, the combination of a median forehead rotation flap and an advancement lateral U-shaped flap offers a simple, visually pleasing repair that preserves the forehead architecture.

Craniocerebral Trauma↗
PubMed2005

Microfoam sclerotherapy.

Sclerosant microfoam is composed of microbubbles of room or air carbon dioxide (CO(2)). When air is mixed into the surfactant liquid sclerosant, microbubbles of reduced diameter can be obtained of sufficient stability to be injected into the vessels. The area of liquid on the surface is enormously increased in inverse proportion to the diameter of the bubble. Polidocanol in microfoam form displaces the blood from the vessel, permitting homogeneous contact between the sclerosant and the endothelium and facilitating endothelial destruction, and is visible in real time by ultrasonography. The concentration and volume of microfoam can be adjusted according to the disease treated. In the case of home-made foams, however, the volume of gas that can be injected is limited by the low solubility of nitrogen, and only the concentration can be modified. CO(2) is a nontoxic and highly soluble physiological gas, and large amounts can be administered. Here, we report the technique and long-term outcomes of ultrasound-guided injection of polidocanol microfoam in the treatment of large varicose long saphenous veins, postsurgical recurrence varicose veins, varicose ulcers, and venous vascular malformations.

Female↗
PubMed2004

Ultrasound-guided injection of polidocanol microfoam in the management of venous leg ulcers.

BACKGROUND: Venous leg ulceration is a frequent and severe complication of lower limb venous insufficiency. Compression therapy is associated with a protracted course of healing and multiple recurrences. Minimally invasive surgery (subfascial endoscopic perforating surgery) is only possible in a subset of patients with leg ulcers. Low-cost and noninvasive therapeutic procedures are needed as alternative treatments. OBJECTIVE: To evaluate the efficacy and safety of sclerosant in microfoam in treating venous leg ulceration. DESIGN: A retrospective study of medical records, pretreatment and posttreatment color photographs, and echo Doppler in patients with venous leg ulceration. All patients were evaluated at 6 months after therapy, 70% were also evaluated at 2 years, 25% at 3 years, and 14% at 4 or more years after treatment. They were assessed for complete (100%) ulcer healing, time to wound closure, and recurrence. SETTING: Private vascular surgery clinic in Granada and dermatology department at a hospital in Pamplona, Spain. PATIENTS: Over 115 months, 116 consecutive patients (mean age [range], 57 [25-85] years) treated with ultrasound-guided injection of polidocanol microfoam (UIPM). INTERVENTIONS: To reduce venous hypertension, UIPM was used to selectively and progressively sclerose sources of incompetence. The number of sessions per patient varied between 1 and 17 (mean, 3.6). MAIN OUTCOME MEASURES: Complete ulcer healing, defined as full reepithelialization of the wound with absence of drainage. Recurrence was defined as epithelial breakdown in the healed limb. RESULTS: At 6-months' follow-up, treatment with UIPM achieved complete healing in 83% of patients (96/116), with median time to healing of 2.7 months; 7 patients were never cured, and 1 patient was lost to follow-up. There were recurrences in 10 patients. CONCLUSIONS: The use of UIPM to selectively and progressively sclerose incompetent veins produced by venous hypertension is highly effective to achieve a stable ulcer healing with minimal invasion, even in elderly patients. Recurrences are easily treatable with this approach. This technique may become a first-line treatment in the management of leg venous ulcers.

Adult↗
PubMed2003

Treatment of venous malformations with sclerosant in microfoam form.

BACKGROUND: Treatment of congenital venous malformations poses a major clinical challenge. Surgery is difficult and frequently unsuccessful, radiological intervention with embolization has an ill-defined role, and conventional sclerotherapy has little to offer. OBJECTIVE: To evaluate the efficacy and safety of sclerosant in microfoam form in treating congenital venous malformations. DESIGN: A retrospective study of medical records, pretreatment and posttreatment color photographs, echo-Doppler ultrasonographic results, and/or magnetic resonance imaging in patients with congenital vascular malformations of venous predominance. Follow-up ranged from 6 to 103 months (mean, 30 months). SETTING: Private vascular surgery clinic in Granada, Spain, and dermatology department at a university hospital in Pamplona. Patients The study population comprised 50 patients, 19 with limited venous malformations, 16 with infiltrating venous malformations, and 15 with Klippel-Trénaunay syndrome.Intervention Percutaneous sclerotherapy by direct injection of 0.25% to 4% polidocanol microfoam under du-plex ultrasonographic guidance. The number of sessions varied between 1 and 46 (mean, 12 sessions). MAIN OUTCOME MEASURE: The primary efficacy end point was defined as a reduction in size after completion of the treatment. RESULTS: Sclerosis therapy with polidocanol microfoam was judged beneficial in 46 (92%) of the 50 patients. Among the 46 responders, 18 showed disappearance of treated malformations, 15 showed a reduction in malformation size of more than 50%, and 13 showed a reduction in malformation size of 50% or less. Of the 39 patients who presented with pain, the pain disappeared in 25 and was reduced in 14. No major adverse effects were reported by any patient. There were 4 cases of transient skin pigmentation and 3 cases of skin necrosis. CONCLUSIONS: Color echo-Doppler ultrasonography-guided sclerotherapy with polidocanol microfoam was effective in 46 (92%) of the patients. The technique is delivered on a strictly ambulatory basis and has proved simple and innocuous. The quality and durability of the outcome make this novel procedure the treatment of choice in the care of patients with congenital venous malformations.

Adolescent↗
PubMed2003

Immunologic escape and angiogenesis in human malignant melanoma.

BACKGROUND: Melanoma escape mechanisms include immunosuppressive and angiogenic cytokine production. OBJECTIVE: We sought to determine vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) expression by immunohistochemistry, and soluble circulating plasma levels of VEGF, bFGF, IL-10, and transforming growth factor-beta2 in patients with different stages of melanoma. METHODS: Biopsy specimens from 42 patients with primary melanoma and 9 with cutaneous metastases were studied by immunohistochemistry. In another 46 patients with melanoma (8 stage I and II; 18, III; and 20, IV) and in 10 healthy control participants, bFGF, VEGF, IL-10, and transforming growth factor-beta2 circulating levels were analyzed. RESULTS: bFGF was positive in 85% and VEGF in 47.5% of 42 primary melanomas. Of 10 patients with primary melanoma (Breslow depth 1.5-3 mm) 6 were VEGF positive and had metastases develop, whereas 4 were VEGF negative and had no metastases at 5 years of follow up. VEGF, bFGF, and IL-10 plasma levels in patients with stages III and IV melanoma were higher than the control group (P <.05 and P <.01, respectively). An inverse relationship was found between VEGF and IL-10. Specifically, in 7 patients with IL-10 levels higher than 10 pg/mL, VEGF levels were less than 49 pg/mL (P <.05); in 9 patients with VEGF levels higher than 100 pg/mL, IL-10 levels were less than 6.7 pg/mL (P <.01). CONCLUSION: VEGF expression in 1.5- to 3.0-mm Breslow depth melanomas may be considered as an unfavorable prognostic factor. Immunosuppressive (IL-10, transforming growth factor-beta2) and proangiogenic (bFGF, VEGF) cytokines are increased in metastatic melanoma. Inverse plasma levels between IL-10 and VEGF in patients with metastatic melanoma are shown in vivo for the first time, the significance of which must be further investigated.

Adult↗
PubMed2002

'Skin popping' ulceration in an HIV patient. Successful treatment with antiretroviral drugs and stanozolol.

Skin popping refers to the practice of injecting drugs beneath the skin without concern for vascular access. We describe a male HIV seropositive injecting-drug user with chronic cutaneous ulcerations on the legs at sites of skin popping. Treatment with antiretroviral drugs and stanozolol was associated with a striking clinical improvement of the ulcer in two weeks. The mechanism of action, improvement of immune function by the antiretroviral treatment or activity of stanozolol on collagen and transforming growth factor-beta1 synthesis, remains unknown.

Adult↗
PubMedDate not supplied

Aggressive tumors of the concha: treatment with postauricular island pedicle flap.

BACKGROUND: The concha is a partially hidden anatomical area characterized by difficult access and reconstruction. OBJECTIVE: We describe the use of the postauricular (revolving door) island pedicle flap in the treatment of aggressive tumors of the concha. METHODS: We present two patients with aggressive cutaneous tumors localized in auricular concha. One of the patients presented with a large ulcerated basal cell carcinoma. The second patient had received a heart transplant, was receiving immunosuppressive therapy, and was affected by a squamous cell carcinoma. RESULTS: Both defects were closed using a posterior auricular island flap that was advanced through cartilage with excellent cosmetic results. CONCLUSION: The postauricular island pedicle flap is well suited for conchal reconstruction because of its proximity to the defect. The flap was transferred from posterior to anterior toward the concha, followed by primary closure of the retroauricular donor site.

Aged↗