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Biomedical subjects

R Ramón

Publications and source records attributed to R Ramón.

At least 37 records · Page 2Linked to original sources
PubMed1997

Unusual locations of osteoarticular tuberculosis.

Tuberculosis continues to occur frequently in some underdeveloped regions. Bone and joint tuberculosis is less common than the pulmonary form. Fourteen cases of bone and joint tuberculosis in unusual locations are presented. Tuberculostatic treatment and surgical approach were associated in all the patients. In 6 cases an arthrodesis of the affected joint was carried out. A surgical debridement was done in 6 patients and a needle biopsy in 2 patients in order to obtain samples for pathology and bacteriology. Twelve of the 14 patients recovered. One patient who was affected by atlanto-axial tuberculosis died within the immediate postoperative period. A second one affected by the acquired immunodefiency syndrome died 4 months after surgery.

Adult↗
PubMed1997

Orifices at the lower neck: heterotopic salivary glands.

Heterotopic islands of salivary-gland tissue are rare and have been described in a number of sites in the head and neck. We describe a patient with salivary-gland fistulas in the lower third of the neck, without evidence of any other congenital abnormalities. The appearance of sinuses in association with heterotopic salivary-gland tissue suggests that its embryologic origin may be from the branchial clefts. Surgical treatment is recommended.

Child↗
PubMed1995

[Specificity of CK-MB enzyme in the diagnosis of acute myocardial infarction in the postoperative period following non-cardiac surgery].

OBJECTIVES: 1) To determine plasma concentrations of creatinphosphokinase-MB (CK-MB) enzyme during non-cardiac surgery for detecting postoperative myocardial infarction or ischemia. 2) To assess the specificity of CK-MB levels for the diagnosis of acute myocardial infarction (AMI) in patients undergoing non-cardiac surgery. PATIENTS AND METHOD: Three hundred twenty-eight patients were studied prospectively. Inclusion criteria were as follows: 1) presenting cardiac risk factors; 2) major surgery; and 3) presence of associated pathology, unrelated to cardiac pathology. All patients were given an electrocardiogram and CK-MB levels were determined every 8 hours over the first 24 hours and on the second and third days. Total CK was measured at 24 hours. RESULTS: AMI was detected by electrocardiogram in 3.3% of the patients. ST-segment/T-wave changes were detected in 5.7% and myocardial ischemia was found in 14.7%. Mean levels of CK-MB in patients with postoperative AMI were significantly higher than in patients without AMI. Total CK levels in patients with electrocardiographic changes were not significantly different from those of other patients. Thoracic surgery produced a significant increase in total CK but no increase in CK-MB. Patients undergoing esophageal surgery presented high initial levels of CK-MB that became normal. CONCLUSIONS: 1) The CK-MB/total CK ratio is highly specific for detection AMI after surgery. 2) Type of surgery affects total CK levels. 3) Detection of high levels of MB fraction should lead to a suspicion of myocardial damage. 4) Total CK level is not a good marker of myocardial necrosis in the postoperative period.

Adolescent↗
PubMed1994

[Peroperative myocardial infarction and myocardial ischemia in non cardiac surgery: prevalence and predictive factors].

BACKGROUND: The decrease in the prevalence of infarction in the population has not been accompanied by a reduction in postinfarct mortality, particularly in the population segment which does not present major symptoms of coronary disease. The aim of the present study was to determine the incidence and predictive factors of cardiac complications in patients undergoing non cardiac surgery. METHODS: Eight hundred seventy-five patients undergoing elective surgery from May 1990-1991 had some of the following criteria: history of heart disease, major surgery, and medical risk other than cardiac. A sample of 328 patients was selected to whom an ECG an CK-MB isoenzyme test were performed on admission, every 8 h, and at the second and third days. Infarction or ischemia were diagnosed by electrocardiographic and enzymatic criteria. Minimum follow up was 72 hours. RESULTS: IAM was diagnosed in 10 cases (3%, confidence interval 95%, 2 to 4%) and ischemia in 47 cases (14%, CI 95%, 11 to 18%). Operative mortality of cardiac origin was 4% (CI 95%, 2 to 6%). Arrhythmia not preoperatively present was detected in 11%, hemodynamic instability in 25%, and sinusal tachycardia in 21%. Other complications were: abdominal 12%, respiratory 14%, neurologic 6% and renal 4%. The appearance of cardiac complications was related with: ASA classification (p < 0.05), previous history of heart disease (p < 0.01), cardiovascular drug administration (p < 0.01) and changes in preoperative electrocardiogram (p < 0.001). CONCLUSIONS: The present study suggests that patients with changes of the ST-T segment in the preoperative ECG should undergo examination to determine the degree of cardiac involvement. A strict peroperative hemodynamic control may reduce the prevalence of cardiac complications in those patients at high risk.

Aged↗
PubMed1994

Bacteriological study of surgical knives: is the use of two blades necessary?

Scalpel blades used in 115 operations were studied bacteriologically. In each case the knife used for skin incision was discarded immediately after the incision and a fresh knife was used to complete the operation. The scalpel blades were cultured in enriched thioglycolate and incubated at 37 degrees C. Readings were taken at 24 and 48 h. From positive cultures, colonies were isolated directly in solid media, and the germ was identified using routine tests. Results showed that there was no bacteriological evidence to justify the use of different blades for skin incision and deep dissection.

Colony Count, Microbial↗
PubMed1994

Tuberculosis of the neural arch. A report of four cases.

Four cases of spinal tuberculosis involving the posterior neural elements are reported; all the patients were from Africa. The condition is rare and its incidence may be different in different races. Neural arch involvement is likely to be associated with neurological complications.

Adult↗
PubMed1994

Pubic osteolysis simulating a malignant lesion: case report.

A case of posttraumatic osteolysis of the pubic bone simulating a malignant lesion in a 55-year-old woman is reported. A review of the literature revealed that all reported cases occurred in post-menopausal women, associated with radiologic evidence of osteoporosis and a history of slight trauma. Biopsy was performed because of the possible malignant nature of the lesion, which should be suspected in all post-menopausal women with a destructive lesion of the pubic bone.

Accidental Falls↗
PubMed1993

Comminuted intra-articular fractures of the distal end of the radius treated with the Hoffmann external fixator.

In 1985 we began a prospective study of the use of external fixation in the treatment of intra-articular comminuted fractures of the distal end of the radius. A total of 30 patients have been treated by this method, representing 1.3% of the total number of patients treated in the Emergency Unit for a fracture of the distal epiphysis of the radius. The use of external fixation in instable fractures of the distal end of the radius improves the anatomic results. These correlate closely with the overall functional results obtained, which were excellent or good in 82.1% of cases, according to the rating system of Gartland and Werley. The main indications are fractures with a high degree of comminution, displacement, and articular affectation (unstable fractures) in young patients, corresponding to Frykman grades VII and VIII.

Adult↗
PubMed1990

Isolated posterior dislocation of the head of the radius in an adult. A case report.

A case of isolated posterior dislocation of the head of the radius is presented. It is a rare entity and, to our knowledge, only 3 adult cases have been published. The mechanism responsible is a fall on the hand with the elbow semiflexed and pronated. A simple reduction is made after an early diagnosis. After a short period in a cast, complete recovery can be expected.

Accidental Falls↗
PubMedDate not supplied

Bronchogenic cyst presenting as a nodular lesion.

We report a subcutaneous bronchogenic cyst in a 7-year-old girl with unusual presentation as a nodular lesion. The cyst was excised and no connection with deeper structures was found. Histologic examination showed the typical features of a bronchogenic cyst. The characteristic clinical and histologic features of bronchogenic cysts are reviewed. The problems of differential diagnosis are also discussed.

Bronchogenic Cyst↗