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Biomedical subjects

A Cortez

Publications and source records attributed to A Cortez.

53 records · Page 3Linked to original sources

[Post-stress nonlithiasic acute cholecystitis. Contribution of ultrasonics to the diagnosis and treatment in 50 cases].

Fifty cases of post-stress acute acalculous cholecystitis were observed during the past 9 years, mainly after major surgery or trauma. The apparently increasing incidence over the last 4 years (42 cases) could probably be explained by a better diagnostic approach of this condition by routine use of ultrasonography. No specific etiological factor could be found; however total parenteral nutrition and/or sepsis and/or use of narcotics could possibly play a role in the appearance of this complication. Although diagnosis can occasionally be suspected in the basis of abdominal and infectious signs, diagnosis was made primarily on the following ultrasonographic signs: enlarged gallbladder with thickened wall, sludge, and occasionally a double-wall aspect and a pericholecystic collection. In this series, most of the patients were treated by cholecystectomy, but a new therapeutic approach was used in 10 cases: percutaneous transhepatic drainage under sonographic control. Outcome is still poor, with a 50 p. 100 mortality rate.

Acute Disease↗

[Small intestine transit anomalies in a patient with chronic abdominal pain and treated for Hansen's disease].

This new case of enteropathy due to Clofazimine provided demonstration of the diagnostic value of small bowel follow-through examination in this complication. Various small intestine anomalies have been reported: ileal or partial jejunal lesions; variations in caliber; loss of physiologic folds; irregularly outlined surface and border lacunae and persistence of suppleness of pathologic loops. Knowledge of these anomalies should avoid exploratory laparotomy, Clofazimine-induced enteropathy regressing after discontinuation of treatment. Repeat small bowel follow up examinations can be performed to review course of this regression.

Abdomen↗

[Carcinosarcoma of the gallbladder. Echographic and anatomopathological diagnosis. Apropos of a case with review of the literature].

Precise diagnosis of carcinosarcoma of gallbladder, a rare tumor, is based on histopathology since clinical and epidemiologic elements fail to differentiate it from other gallbladder cancers. Ultrasound imaging is the most effective radiodiagnostic technique since it allows visualization of the tumor and suggests the presence of a carcinosarcoma when a polypoid or vegetating mass is detected within the gallbladder.

Aged↗

[Enteropathy caused by clofazimine].

A case of Clofazimine enteropathy is reported, diagnosed on the demonstration of red brown birefringent crystals in the small bowel mucosa and submucosa as well as in the mesenteric lymph nodes whereas the clinical and radiological signs appear to be non specific. After the withdrawal of the drug, a clear improvement of the symptoms was achieved only under a gluten free diet. The possibility of such accidents, sometimes lethal, suggests the restriction of clofazimine to leprosy.

Clofazimine↗

A study of the quantal (all-or-none) change in reflex latency produced by opiate analgesics.

The properties of opiate-induced changes of tail-flick latency were studied in the rat. (1) Morphine and pentazocine produced a stepwise increase in latency which rose from near baseline to cut-off (usually greater than 20 sec) in less than 30 sec. Abrupt return to pre-treatment latencies was observed either spontaneously or when the rat was back-titrated with the narcotic antagonist naloxone. (2) The proportion of rats showing this stepwise change increased with increasing dose; however, the step itself was independent of dose. The same step was produced by a slow, constant infusion of morphine but was not produced by ice-water stress or barbiturate administration. (3) Increasing heat intensity to the tail shortened the baseline latency and raised the mean dose of morphine required to produce a step latency increase. (4) A step increase in latency was also observed when paw withdrawal instead of tail-flick was measured. We hypothesize that the analgesic behavior described partly defines the operating characteristics of an intrinsic endorphin-mediated analgesia system which mediates narcotic suppression of withdrawal reflexes.

Animals↗

Mechanism of inappropriate polyuria in septic patients.

Inappropriate polyuria leading to hypovolemia and hypotension occurs frequently in severely septic patients. It's etiology was studied in three patients with polyuria and systolic hypotension. Glomerular filtration rate and renal blood flow were measured by the standard renal clearance techniques. Renal blood flow distribution to the outer cortex, inner cortex-outer medulla, and the inner medulla were measured by radioactive xenon. The glomerular filtration rate, renal blood flow, and renal blood flow distribution were normal. Polyuria does not result from a maldistribution of renal blood flow. Antidiuretic hormone did not alter the polyuric syndrome. These data suggest that sepsis produces a blockade at either the distal tubule or the collecting duct, thereby preventing salt and water conservation. This blockade may be due to either a toxin or a toxic metabolic breakdown product of sepsis.

Adult↗

Questionable value of furosemide in preventing renal failure.

The effects of furosemide on renal function and hemodynamics were evaluated in 54 critically ill surgical patients. Standard clearance techniques were used to measure glomerular filtration rate (GFR), renal plasma flow (RPF), osmolar clearance (COsm), sodium clearance (CNa), and renal blood flow (RBF). RBF distribution to outer cortex, inner cortex-outer medulla, and inner medulla was measured by the radioactive xenon disappearance technique. Furosemide produced a marked rise in urine output, COsm, and CNa; it produced no change in GFR, RPF, RBF, and RBF distribution. Twelve of the 54 patients received furosemide for therapy not related to the study; six patients developed renal failure and five became hypotensive 2 to 10 hours after administration of furosemide. These data demonstrate that furosemide does not protect against renal failure by altering or increasing RBF but may cause renal failure by producing hypovolemia.

Acute Kidney Injury↗

A simplified method for the gas-liquid chromatographic determination of methyl mercury in fish and shellfish.

A simple acetone wash of the fish sample which removes lipids and other organic materials replaces the cystein cleanup specified in other methods. Methyl mercury is freed by hydrochloric acid, extracted into benzene, and determined with a gas-liquid chromatograph equipped with an electron capture detector. The method is quantitative for methyl mercury levels as low as 0.10 ppm in fish and shellfish. Ethyl mercury chloride may be used as an internal standard to detect unsuspected error or instrumental parameter variation.

Animals↗

The surgical implications of estrophile protein estimations in carcinoma of the breast.

Assays of estrophile protein (ER) in 161 patients with no previous additive or ablative hormonal therapy have been analyzed; 47.2 percent were ER positive; 52.8 percent ER negative. A total of 37.5 percent of premenopausal and 50.8 percent of postmenopausal patients had ER-positive tumors. The effects of additive and ablaive hormonal therapy were observed in 75 patients; 63.5 percent of the ER-positive group and 8.6 percent of the ER-negative group responded, but the incidence in the ER-negative group is thought to be spuriously high. The level of the ER content in the ER-positive group did not influence the degree of response. The ER-negative group had a shorter life span after discovery of the tumor and was more likely to develop dominant visceral metastases. Of 15 patients followed with sequential ER assays after hormonal therapy (additive and/or ablative), 14 demonstrated substantial falls in ER levels but these did not correlate with the clinical response. Tumor assayed in nine patients after irradiation of the lesion contained no demonstrable ER. ER assays of breast cancer tissue proved to be a useful but imperfect tool in predicting clinical progress following hormonal maneuvers but some readings may be spuriously low due to imperfect techniques of measurement, prior exogenous hormonal administration or hormonal ablation, and previous irradiation of the tumor.

Adrenalectomy↗

Endometrial tumor invasiveness is related to metalloproteinase 2 and tissue inhibitor of metalloproteinase 2 expressions.

Matrix metalloproteinase (MMPs) expression has been linked to gynecological tumor aggressiveness. The objective of this study was to determine MMP-2, MMP-7, and MMP-9 and tissue inhibitors of metalloproteinases (TIMP)-1 and TIMP-2 expression in endometrial malignancies and their relation to clinical and histologic parameters. Formalin-fixed, paraffin-embedded tumor samples from 50 patients with endometrial carcinoma treated between 1999 and 2004 were stained with specific monoclonal antibodies. The tumors were grouped according to the FIGO classification. The staining results were compared to histologic and clinical data. Semiquantitative analysis of MMP and TIMP expression showed a significant difference in TIMP-2 expression according to the histologic subtype (P = 0.03) and also a trend towards a difference in MMP-9 expression (P = 0.05). MMP-2 expression increased and TIMP-2 expression fell as the histologic grade increased (P = 0.0007, P < 0.0001, respectively). MMP-2 expression correlated with lymph node metastasis (P = 0.04), while TIMP-2 expression correlated with the depth of myometrial invasion (P = 0.01), vasculolymphatic space involvement (P = 0.02), and lymph node metastasis (P = 0.0003). These results support the involvement of MMPs and TIMPs in endometrial tumor growth and progression. High MMP-2 and low TIMP-2 expression were the most potent markers of endometrial tumors with a high risk of local and distant spread.

Carcinoma↗