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Biomedical subjects

T Castillo

Publications and source records attributed to T Castillo.

27 records · Page 2Linked to original sources
PubMed1983

The effect of head position on intracranial pressure in the neonate.

Elevation and maintenance of the head in an elevated, midline position reduces cerebral venous and intracranial pressure (ICP) in adult neurosurgical patients. To determine the possible effect of head position on ICP in the neonate, we studied 26 neonates less than 2500 g at birth and less than or equal to 10 days of age. ICP was measured in each of 4 different head positions: head turned to the right and bed horizontal (R-0 degrees); head turned to the right and head of the bed elevated 30 degrees (R-30 degrees); head in the midline and bed horizontal (M-0 degrees); and head in the midline and head of the bed elevated 30 degrees (M-30 degrees). ICP results were as follows: R-0 degrees, 10.0 +/- 1.2 (mean +/- SEM), cm H2O; R-30 degrees, 8.6 +/- 1.3 cm H2O; M-0 degrees, 6.9 +/- 1.2 cm H2O, and M-30 degrees, 5.3 +/- 1.0 cm H2O. ICP was significantly lower in the M-0 degrees and M-30 degrees positions when compared to either R-0 degrees and R-30 degrees. When the effect of elevating the head of the bed 30 degrees was evaluated for infants whose ICP was greater than or equal to 7 cm H2O in the R-0 degrees and M-0 degrees positions, it was noted that there was a significant drop in ICP in the elevated positions. These data suggest that head position influences ICP significantly in the neonate probably due to venous congestion caused when the neck is turned, and hydrostatic pressure changes when the head of the bed is elevated. ICP fluctuations due to changes in head position may be deleterious to the infant at risk for intracranial hemorrhage (ICH) or cerebral edema.

Head↗
PubMedDate not supplied

[Colorectal cancer: study on 365 cases].

We report a clinic-endoscopical study about 365 patients, both of sex, between 26-95 years old, with colonoscopic diagnosis of colorectal cancer. Results showed that 61,92% were men and 38,08% women; in 92,60% the disease ocurred over 40 years old. 13,42% had malignant personal history -colorectal cancer, uterus and breast cancer, and others-; 13,97% had bening personal history-colorectal adenoma, cholecystectomy, and others-; Abdomina pain, change in intestinal habits, and bleeding were the moist frequent symptoms, with differences depending of the tumors localization in the colon or rectum. 62,57% of patients had anemia under 10g% of hernoglobin; in 85,23% the fecal occult blood test was positive. On 199 patients, the simple barium enema diagnosed the tumor in 66,33% only; but in the same group, colonoscopy diagnosed the cancer in 96,49% at first examination. In all patients, colonoscopywas excellent for diagnosis of the principal lesion, and for the identification of synchronous neoplasia. On 365 patients, colonoscopy diagnosed the cancer in 98,08% at first examination. The localization of tumors was: 57,63% in left colon (49,47% in rectum and sigmoid colon); 34,21% in the right colon; and 8,16% in transverse. Pathology showed that adenocarcinoma was the most frequent tumor 95,23%; 1,06% mucoid carcinoma; 1,06% epidermoid carcinoma; and 2,65% lymphorna. In 32,05% of cases there were synchronous lesions; 3,01% had other cancer, and 54 patients had 112 polyps (62,50% adenomatous polyp, 6,25% adenoma with non invasive or invasive adenocarcinoma, and 31,25% hiperplastic polyp. Authors emphasize the value of the detection and early diagnosis to decrese the colorectal cancer mortality.

Abdominal Pain↗
PubMedDate not supplied

[Colonoscopic diagnosis].

Between 1974 and 1992, we perform 3,054 colonoscopies for diagnosis in 2,770 patients, both of sexes, between the ages of 1 and 101 yr, most of them over the fifth decade of life. In 300 procedures the bowel cleansing was made with the standard method of liquid diet and enemas, and in the other 2,754 with the oral administration of saline solution 9% with optimal results. We get the sedation of patients with the intravenous administration of diazepam 10mg, or pethidine 50 mg, or midazolam 2.5 to 5 mg, and in children with ketamine and the anesthesiologist assistance. In 95% of the procedures we can see the cecum and the ileum; the diagnosis was abnormal in 52.78% of cases, normal in 45.20%, and insufficient in 02.02% specially for a bad cleansing of the bowel. In the abnormal group, the most frequent diseases we diagnose were: polyps, cancer, diverticular disease, and specific inflammatory disease of the bowel like TBC, radiation proctosigmoiditis, amebiasis, and non-specific bowel disease: "colitis", ulcerative proctocolitis, erosive colitis, and Crohn's disease. Colonoscopy is a very important method for diagnosis of colon diseases, alone or complementary of double contrast X-ray of the colon.

Adolescent↗
PubMedDate not supplied

[Therapeutic colonoscopy in patients with colonic and rectal polyps].

598 colorectal polyps were removed by therapeutic colonoscopy from 377 patients, of both sexes, between 1 and 88 years old, most of them with lower digestive symptoms. The polyps were unique in 67.37% and multiple in 32.63% of patients, and mostly located in rectum and sigmoid colon; 42.14% were pedunculated, 33.95% sessile++/sub-pedunculated, and 23.91% sessile in shape. In 51% the size was over 10 mm in diameter. Histologically, 68.68% were of epithelial neoplastic type: 60.91% adenoma; 6.42% adenoma with adenocarcinoma, and 1.35% polypoid carcinoma. 30.64 were epithelial non-neoplastic type: 20.32% hyperplastic polyp, and 0.51% hyperplastic polyp with tubular adenoma. Two patients (0.53%) had lower digestive hemorrhage immediately after the polypectomy. The complications were controlled with conservative measures without blood transfusion.

Adolescent↗
PubMedDate not supplied

[Emergency endoscopy in upper digestive hemorrhage].

In our hospital the incidence of upper digestive hemorhage [UDH] is greater after the 4th decade of age and predominantes in the male sex. The patients' clinical data was important in the diagnosis of the lesion. In 63% of our cases a close relation was found between the previous intake of substances considered ulcerogenous and the hemorrhagic episode, as well as the presence of stress situations. In our experiences the causes of UDH in order of their frequency are: 1. Acute lesions of the gastric mucosa. 2. Duodenal ulcer. 3. Gastric ulcer. 4. Stomal ulcer. 5. Bleeding esophagitis. 6. Others. The digestive hemorrhages of undetermined caused corresponded to 2,33% of the cases. The early diagnosis of UDH by means of emergency endoscope was of great value in the therapeutic handling of patients.

Adult↗
PubMedDate not supplied

[Adenoma of the colon and rectum].

318 adenomatous polyps were removed by colonoscopic polypectomy, from two hundred patients, between 25 to 88 years old; 60.50% men, and 39.50% women. 86.50% of patients were older than 50 years old. In 64.50% of patients the adenomatous polyp was single, and 35.50% had "multiple adenoma"; the lesions distribution was 72.64% in the rectum-sigmoid colon. The grade of dysplasia was severe in adenomas over 20mm, and in those of villous type. The malignant percentage was: 1.61% in the adenomatous polyp under 10mm in diameter, 8.49% in those of 10mm to 19mm, and 30.68% in the adenomas of 20mm or more. The adenocarcinomatous focus increased from 1.69% in the adenomas under 10mm to 58.33% in those of 40mm or more in diameter. The relationship between type of adenomatous polyp and his adenocarcinoma incidence was 7.66% in tubular type, 22.22% in tubular-villous, and 26.32% in villous type. The carcinoma incidence in all of the adenomas of this series was 11.95%.

Adenoma↗