Biomedical subjects

R Poblete

Publications and source records attributed to R Poblete.

15 recordsLinked to original sources

PubMed2001

Traumatic phacocele.

We report a case of traumatic phacocele in a 42-year-old patient with a history of congenital glaucoma and bilateral goniotomies as an infant. Her left eye had little vision and poorly controlled intraocular pressure but was comfortable until her presentation after blunt trauma. Phacocele or subconjunctival dislocation of the crystalline lens is a rare consequence of blunt trauma, particularly in a patient whose only previous ocular surgery was goniotomy more than 40 years ago.

Adult↗

PubMed1993

Cranial neuropathy heralding otherwise occult AIDS-related large cell lymphoma.

Three HIV-infected patients developed cranial neuropathy as the initial manifestation of an AIDS-related large cell lymphoma. All were homosexual men known to be HIV seropositive for 3 to 4.5 years. At the time of presentation for neurological disease, the CD4 T-lymphocyte count was < 400 cells/mm3 in each. Initial manifestations were retro-orbital headache and oculomotor nerve palsy in two and an abducens nerve palsy in the other. Repeatedly negative CSF cytologies and recovery of the cranial neuropathy obscured the diagnosis. These patients illustrate that cranial neuropathy with HIV infection may herald the presence of an occult large cell lymphoma. Spontaneous or corticosteroid-associated improvement of the cranial neuropathy, absence of abnormalities on brain imaging studies, and negative CSF cytologies do not exclude this diagnosis. We suggest that a diligent and repeated search for lymphoma be considered in HIV-infected patients presenting with cranial neuropathy, including repeated CSF examinations, MRI of brain and spine (T1 and T2) with and without gadolinium enhancement, chest and abdominal CT scans, and bone marrow biopsy.

Adult↗

PubMed1993

[Protein and energy requirements in patients with severe head injury].

The aim of the present study was to assess the effect of severe head injury over resting energy expenditure and nitrogen losses. Eight patients with severe head trauma (mean Glasgow scale of 4.9 +/- 1.6), subjected to emergency craniotomy were studied; four patients had septic complications and none received steroids. Energy expenditure was measured using indirect calorimetry and nitrogen losses were assessed measuring 24 h urea nitrogen excretion on days 1, 4, 7 and 10 of the postoperative period. Twelve healthy males composed the control group. Measured energy expenditure in patients, evaluated in 22 occasions, was 35 +/- 9.8 Kcal/kg/day or 145 +/- 41% of the estimation according to Harris-Benedict equations, compared to 22.0 +/- 4.6 Kcal/kg/day or 89.9 +/- 17.5% in the control group (p < 0.001). 24 h urinary urea nitrogen excretion in patients was 18 +/- 12 g/day (range 5.2-46.9) and the catabolic index was 7.4 +/- 13.5. It is concluded that, due to the great individual variability in measured energy expenditure in these patients and their hypercatabolism, indirect calorimetry and nitrogen balance studies become useful tools to perform an adequate nutritional support.

Adolescent↗

PubMed1988

Nosocomial transmission of tuberculosis from unsuspected disease.

Tuberculosis remains an occupational hazard for hospital employees. A case of acute generalized tuberculosis occurring in a patient with a malignancy who had received corticosteroids was undetected during life and during a gross autopsy examination. Histologic examination of tissue performed one month later was necessary to establish the diagnosis. Of susceptible hospital staff members who were exposed to the index case, infection developed in nine of 56 (16 percent) compared with three of 333 (0.9 percent) unexposed personnel with similar risk but no known exposure (p less than 0.001). This was a 17.8-fold increase in the infection rate for the exposed group. Three employees infected had evidence of active disease: two had pleural effusions and one had cavitary pulmonary infiltrates; six were asymptomatic. The high rate of infection was associated with inadequate air ventilation and exposure to uncontained infectious aerosol. Preventive therapy with isoniazid, high-change-ventilating systems, ultraviolet radiation, and primary barrier systems are recommended methods to reduce the infection risk.

Air Microbiology↗

PubMed1987