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Rolando Montenegro

Publications and source records attributed to Rolando Montenegro.

4 recordsLinked to original sources
PubMed2005

Structural evaluation of plasma alpha2-macroglobulin in acute pancreatitis.

In this work we evaluate the proteolytic state of plasma alpha2-macroglobulin in acute pancreatitis. In addition, the plasma activity of matrix metalloproteinase-2 (MMP-2), MMP-9 and serine proteinases were analyzed. A total of 33 patients with acute pancreatitis were studied, of whom 16 were diagnosed as having mild and 17 as having severe acute pancreatitis. In the latter group, three patients progressed to multi-organ failure and died as a consequence of these complications. The proteolytic fragmentation of alpha2-macroglobulin was evaluated by Western blotting, whereas the plasma activity of MMP-2, MMP-9 and serine proteinases was evaluated by gelatin zymography. Enhanced fragmentation of alpha2-macroglobulin was detected in severe acute pancreatitis patients with multiple organ failure and lethal complications. In this same patient group, increased plasma activity of the active forms of MMP-2 and MMP-9, as well as serine proteinases, was apparent. In addition, we demonstrate that chymotrypsin-like proteinases could be the principal cause of alpha2-macroglobulin degradation in this group of patients. Our results indicate that secondary proteolysis of alpha2-macroglobulin promotes impaired control of extracellular proteolytic activity, leading to local and distant tissue injuries during severe acute pancreatitis. Finally, the structural evaluation of plasma alpha2-macroglobulin could be used as a prognostic marker of the severity of acute pancreatitis.

Acute Disease↗
PubMed2003

[Present state in the surgical treatment of acute cecal diverticulitis].

BACKGROUND: Cecal acute diverticulitis is a rare disease with symptoms similar to acute appendicitis and is therefore difficult to diagnose. OBJECTIVES: To evaluate therapeutical conduct according to clinical for ms of presentation and the intraoperative findings. LOCATION: Emergency Service of Clinical National Hospital. U.N.C. (Cordoba National University), and the ABC group. DESIGN: Retrospective observation. MATERIALS AND METHODS: Twenty-four patients with cecal diverticulitis were treated surgically, of which seventeen were men and seven were women with an average age of 47 years. The first group was formed with 16 patients and the second with 8. All patients presented abdominal pain, fever, nausea and vomiting when they were admitted, but one showed enterorrhagia and 2 abdominal distention and ileus. Physical examination produced pain and tenderness in RLQ, but in 6 peritoneum was not involved and in 4 a tumor was palpable in that region. Two patients, had a perforating acute abdominal condition. RESULTS: Sixteen right hemicolectomies were performed. In the remaining eight a cecostomy was decided. One patient died due to TEPA (Acute pulmonary thromboembolism). Abdominal wall abscesses appeared in six patients, and in four of them an incisional middle hernia appeared in postoperative period. CONCLUSIONS: We consider that in those patients presenting serious problems in deciding whether the inflammatory condition was benign or malignant, or when perforated cecal diverticulum with vascular compromise and subsequent cecal wall necrosis has been suspected, we believe that the resection is the best treatment.

Acute Disease↗
PubMed2003

[Acute carotid thrombosis in penetrating traumatism: is revascularization necessary in the patient without central neurological deficit?].

INTRODUCTION: Carotid lesions require priority in both evaluation and treatment due to their high morbidity and mortality. Controversy about therapeutic behavior in these patients with or without central neurological deficit is still under in discussion. OBJECTIVES: To present a patient with acute carotid thrombosis due to a shotgun wound and discuss its therapeutic behavior. SETTING: Hospital de Urgencias in Córdoba city. MATERIAL AND METHODS: A 15-year-old male patient is presented with a "point-blank" shotgun wound in the soft parts of the left cervical region, and a left carotid thrombosis with no central neurological deficit. RESULTS: Wound toilette and carotid revascularization by means of resection and venous by-pass with external carotid ligature was performed. The procedure was finished by delaging for plastic reconstruction of the cervical injury. Carotid postoperative angiographic control showed good permeability with no carotid flow alteration. CONCLUSION: Penetrating carotid injuries should be resolved, if technically possible, with revascularization of the carotid sector. This procedure has to be aborted if the patient is in coma or the lesion is difficult to repair, in such a case ligature should be carried out.

Acute Disease↗