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Biomedical subjects

R Martínez García

Publications and source records attributed to R Martínez García.

15 recordsLinked to original sources

[Systemic lupus erythematosus in the pregnant patient. Implications for anesthesia].

A 28-year-old woman with systemic lupus erythematosus and a history of aseptic meningitis, digestive bleeding due to thrombopenia and deep venous thrombosis underwent elective cesarean for transverse presentation at 35 weeks. Preoperative blood work-up showed an antinuclear antibody titre that was slightly positive and steroid treatment was started. Surgery operation was performed with general anesthesia. The outcome was satisfactory even though serious complications can develop during the management of anesthesia in such patients. Systemic lupus erythematosus is a chronic, multisystemic disease that mainly affects women of childbearing age. Antibodies and immunocomplexes play a fundamental role. Given the multiorgan involvement in this disease, preoperative study of the lupus patient should assess all such involvement, including maternal-fetal risk, as well as consider the drug and anesthetic management to be applied. Among the clinical signs that can affect management of anesthesia are the following: aseptic meningitis, high blood pressure, pericarditis, pneumonitis and recurrent venous thrombosis. Anemia, thrombopenia and significantly altered coagulation events are common.

Adult↗

[Cystic lymphangioma of the adrenal gland in adults. Review of the literature and report of a new case].

Presentation of one case of cystic lymphangioma of the suprarenal gland in a 34-year-old female patient with a background of lower urinary tract infections, presenting with continuous and aggravating pain in left lumbar area and with no other associated symptomatology, diagnosed with ultrasound, IVU and CAT. A review of the literature is made. The present study pretends to give an overall view of a rare and benign disease, commenting upon the difficulties found in its diagnosis and the different therapeutical options.

Adrenal Gland Neoplasms↗

[Efficacy of antimicrobial prevention with single-dose ceftriaxone in urologic surgery].

One gm ceftriaxone was administered i.m. to 266 patients 1 h before urologic surgery. The antimicrobial spectrum and long half life of this beta-lactam make it potentially useful for prophylaxis. Its efficacy was determined by the incidence of infections and antibiotics required postoperatively. Postoperative bacteriuria was determined by two urine cultures: one at discharge from hospital or after catheter removal and another 4 weeks postoperatively. The overall postoperative infection rate was 9.7% and bacteriuria was 11.2%; most of these were asymptomatic. Antibiotics were administered postoperatively in 13.9% of the patients. The foregoing results corroborate the efficacy of this agent given in a single dose for prophylaxis against infection in urologic surgery.

Ceftriaxone↗

[Urachal leiomyoma].

A case of leiomyoma of the urachus is reported herein. A review of the literature revealed only 6 cases have been reported. Its incidence is suspected to be higher, but this tumor type is only detected when it is large enough or when complications arise such as bleeding, infection, etc. There is no other data of interest except for its rarity.

Adult↗

[Variant hairy-cell leukemia: immunophenotypic and ultrastructural study of a case].

The recent introduction of new methods to identify different lymphocytic subsets has made it possible to recognise a rare variant of the classic hairy cell leukaemia, showing intermediate features between prolymphocytic leukaemia and hairy cell leukaemia. A 37-year-old patient is reported who followed a mildly aggressive clinical course and had massive splenomegaly without lymph node enlargement. Moderate leucopenia with lymphocytosis was present, with frequent hairy cells carrying one prominent nucleole. The cytochemical pattern include tartrate-sensitive acid phosphatase positivity, and the immunophenotype of such cells was CD22++, CD11++, CD24-, CD25-, CD2-, CD5-, CD19++. No lamellar ribosomal complex was seen in the ultrastructural study of the hairy cells. The patient was diagnosed as having variant hairy cell leukaemia and achieved partial response after splenectomy. The clinical, diagnostic and therapeutic aspects of this rare variant are discussed.

Adult↗

[Renal liposarcoma: diagnostic and therapeutic considerations].

We report on two cases of renal liposarcoma. The clinical features of this tumor type are described and diagnostic and therapeutic considerations are put forward. The usefulness of CT in the diagnosis of this disease entity is underscored. This permits us to evaluate the response to treatment and furthermore, it permits early detection of recurrence.

Female↗

[Diagnosis and treatment of renal angiomyolipoma].

Fourteen cases of angiomyolipoma have been diagnosed and treated at our center since it opened 19 years ago. The diagnostic methods and therapeutic approach have changed since then. Noninvasive imaging techniques like CT and ultrasound have significantly enhanced the accuracy of diagnosis. The mode of presentation, number, size and the differential diagnosis may decide between conservative or surgical management of these tumors. A small tumor mass only requires observation. For larger ones, the treatment of choice is preferably by conservative surgery or highly selective embolization if permitted by the severity of the disease. Surgery is warranted when doubt exists on CT and ultrasonography.

Adolescent↗

[Carvernosometry in impotence: method and standardization of normal values].

Cavernosometry and cavernosography in conjunction with artificial erection have been included in the protocol for the evaluation of sexual dysfunction in the male. The device is comprised of a volumetric infusion pump with a digital flow indicator, and the technique employed is bilateral puncture of the corpora cavernosa. Pressures are recorded by one needle while saline and contrast medium are introduced through the other. Eight males with no organic disorder were assessed for erection flow (EF) and maintenance flow (MF) to determine the normal and pathologic values for this method of evaluation. These values have a normal distribution. Calculation using formulas with a 99% reliability gave the following as pathological values: EF greater than 181 ml/min. or MF greater than 99 ml/min.

Erectile Dysfunction↗

[Intestinal tuberculosis. A diagnostic challenge].

Tuberculosis (TB) is a common disease in Spain, whose incidence has increased due to AIDS, immunotherapy and immigration. Intestinal disease is rare and can be difficult to diagnose because its symptoms and laboratory results are nonspecific. In addition, endoscopic lesions resemble those of other diseases such as Crohns disease (CD). Differentiating between intestinal TB and CD is very important since steroid treatment con be life saving in CD and lethal in intestinal TB. Colonoscopy plays an important role in establishing a suspected diagnosis. The endoscopic findings most characteristic of intestinal TB are circular ulcers, small diverticula (3-5 mm), and sessile firm polyps. The suspected diagnosis must be confirmed by the presence of caseating granulomas and/or acid fast bacilli. Polymerase chain reaction is currently recommended for assessing the presence of tubercle bacilli in tissue specimens obtained by endoscopic biopsy. We report a case of intestinal TB in a female renal transplant recipient that demonstrates the difficulty of making this diagnosis.

Colonic Diseases↗

[Tetraplegia in the immediate postoperative period of stapedectomy].

Management of the cervical spine in orotracheal intubation for general anesthesia is an important aspect of daily practice in anesthesiology. Also important are the requirements, techniques and consequences of patient position during surgery. We report a case of tetraplegia during the early postoperative period after stapedectomy for otosclerosis. After surgery, the spontaneously breathing patient was transferred to the recovery room, where a clinical picture of anesthesia and paralysis of all four limbs was evident. We ordered an emergency magnetic resonance image of the cervical spine, which revealed a massive acutely herniated disk at C6-C7 with signs of ischemia or necrosis of the medulla at the same level. After eight months, the patient was still paraplegic and lacked sensation in the lower limbs. Sensation and motor function in the upper limbs was nearly normal. We review the etiopathogenetic mechanisms that might be responsible for this clinical profile.

Adult↗

[Adenocarcinoma of the kidney pelvis].

We present a case of primitive renal pelvis and calix adenocarcinoma. The clinical evaluation was carried out by means of UIV, echography and TC. Although the tumoral type diagnosis is histologic, the clinical manifestations of chronic renal infection-inflammation, whether associated with obstruction and/or lithiasis or not, are suggestive of this possibility.

Adenocarcinoma↗