Search PubMed⌕ Search

Biomedical subjects

A Gil Aguado

Publications and source records attributed to A Gil Aguado.

At least 19 recordsLinked to original sources
PubMed2003

[Multiple paraganglioma: careful with surgery!].

INTRODUCTION: Extraadrenal paragangliomas are exceptional tumors. They prevail the carotid, jugulotympanic, and vagal ones. They are frequently multiple and its treatment is controversial in view of the fact that bilateral removal can go with severe morbidity. The case of a patient with bilateral paraganglioma and postoperative baroreflex dysfunction with severe arterial hypertension and hypotension episodes is presented. CLINICAL OBSERVATION: A 23-year-old woman with a diagnosis of left carotid and right vagal paraganglioma by TC and angiography. In January 1999 the left carotid paraganglioma was operated. The patient showed dysphonia, dysphagia, and lingual dysmotility in the postoperative course, with spontaneous improvement after some months. In December 1999, after the removal of the right vagal paraganglioma, the same complications appeared and hypertension crises (230/140), associated with headache, dizziness, and rash, and alternating with severe hypotension episodes (70/50). Blood biochemistry and the levels of cortisol, thyroid hormones, catecholamines, and metabolites were normal. Imaging techniques discarded tumor at another level and the registry of the ambulatory monitoring of blood pressure (AMBP) confirmed an important pressure lability. The neurophysiological study of the autonomous nervous system demonstrated the failure of the fast regulation mechanisms of the blood pressure. With the diagnosis of baroreceptors dysfunction and paralyses of cranial nerves IX, X and XII a treatment with clonidine was started with poor tolerability and incomplete response. DISCUSSION: This case illustrates the treatment difficulties of paragangliomas, especially when they are bilateral, and in which the surgery can go with severe morbidity. Baroreflex dysfunction should be entertained in the differential diagnosis of the extreme pressure lability.

Adult↗
PubMed1998

[Prevalence of psychiatric disturbances and psychopathologic status in patients with systemic lupus erythematosus].

BACKGROUND: Psychiatric disorders are commonly associated with systemic lupus erythematosus (SLE). Some authors consider that these disorders can be associated with cognitive impairment. OBJECTIVES: The objectives of this study were to establish the particular prevalence of psychiatric disorders in these patients and to investigate the relationship between psychiatric disorders, cognitive impairment, life quality, psychological status and adjustment to illness. MATERIAL AND METHODS: A cross-sectional study is reported of 46 spanish patients with systemic lupus erythematosus (SLE) attending the outpatients clinics of the Internal Medicine and Rheumatology Departments at a University Hospital. The following instruments were used: a Structured Clinical Interview for DSM-III-R, the Nottingham Health Profile, the Symptom Check-List 90-Revised, the Psychological Adjustment to Illness Scale and the Integrated Program of Neuropsychological Assessment Test-Barcelona. RESULTS: The prevalence of psychiatric disorders at interview was 33%. The most common diagnoses were affective disorders and psycho-organic syndrome. Affective disorders were associated with a poorer life quality, number of hospitalizations and psychiatric background. Adjustment to illness accounted for the psychologic status of the patients.

Adult↗
PubMed1998

[Acute myocardial infarction secondary to Wegener's granulomatosis].

Wegener's granulomatosis (WG) is a necrotizing and granulomatous vasculitis that usually affects the upper and lower respiratory tract and the kidneys. Cardiac involvement is rare although pericarditis, coronary arteritis, myocarditis, valvulitis and arrhythmias have been described. Acute myocardial infarction with clinical expression is an exceptional complication of Wegener's granulomatosis. We report a case of a 30-year-old man with Wegener's granulomatosis who suffered an acute myocardial infarction during the initial phase of the disease, following seven days of treatment with glucocorticoids and cyclophosphamide. Transthoracic echocardiography showed abnormal regional wall motion with septal hypokinesia and apical akinesia. Cardiac catheterization revealed an ectasic segment in the proximal left anterior descending coronary artery and total occlusion in the mid-segment. Medical therapy with prednisone and cyclophosphamide was continued. No complications and initial remission were achieved.

Adult↗
PubMed1996

[Radiologic digestive manifestations in patients with antibody deficiency].

UNLABELLED: In order to establish a relationship between radiological and clinical data and/or early diagnosis of the complications frequently found in patients with hypogammaglobulinemia, we carried out gastrointestinal series (GIS) in 47 patients mean age 22.5 years with hypogammaglobulinemia or primary antibody deficiencies. RESULTS: 15 patients did not show any radiological abnormalities. Nodular lymphoid hyperplasia (NLH) was found in 23 cases. None of the patients with NLH had gastrointestinal symptoms. Radiologic signs of malabsorption were present in 15 cases. 2 patients with radiologic signs of malabsorption (mean age 12 years) did have clinical or laboratory finding suggesting a malabsortive syndrome. Moreover, 2 patients showing clinical manifestations of malabsorption did not show any significant radiological findings. 4 patients were diagnosed of chronic atrophic gastritis (CAG) by means of endoscopy and gastric biopsy, whereas only in one of these cases GIS showed gastric fold atrophy, compatible with the pathologic diagnosis of CAG; 2 of these patients progressed to gastric cancer, a diagnosis that was done by endoscopy. CONCLUSIONS: We have observed that NLH is more frequent in patients with hypogammaglobulinemia than in the normal population, it is asymptomatic and may be diagnosed by radiological methods. The radiological findings of malabsorption do not correlate with the clinical data. A combination of endoscopy and gastric biopsy is the method of choice for the early diagnosis of atrophic gastritis and gastric cancer, since the radiological alterations found in GIS appear at late times. We conclude that GIS supplies few data to the study of digestive manifestations in patients with hypogammaglobulinemia, except in the case of NLH.

Adolescent↗
PubMed1994

Massive cerebral calcification in systemic lupus erythematosus: report of an unusual case.

A 38-year-old woman with systemic lupus erythematosus (SLE) and an acute neurological event was studied with computed tomography (CT) and magnetic resonance (MR). Marked intracranial calcification mimicking that seen in hypoparathyroid states was found. The clinical significance of this finding is not clear and the mechanism for cerebral calcification remains unknown.

Adult↗
PubMed1993

Malignancy in systemic lupus erythematosus: a report of five cases in a series of 96 patients.

The association of systemic lupus erythematosus (SLE) and malignancy has been reported previously and suggests an increased risk of cancer in this disease. Lymphomas are the most frequent neoplasias reported in these patients and carcinoma of the cervix and breast are also seen. Several factors probably play a role in the aetiology of malignancies associated with SLE including intrinsic disturbances of immunity and concomitant immunosuppressive therapy. We report five solid tumors (one breast carcinoma, one squamous cell carcinoma of the anus, one adenocarcinoma of the rectum, one carcinoma of the cervix and one carcinoma of the gallbladder) among 96 patients with SLE. The most striking finding in this study was the absence of haematological malignancies. The incidence of malignancy in the series, the age of diagnosis of SLE and neoplasia and the time delay between SLE and malignancy diagnosis was similar to other series. We did not find any clinical or immunological feature that predicted the development of neoplasia. In conclusion, patients with SLE may have the same malignancies as the general population after adjustment for age and sex. There are no predictive indicators for malignancy and immunosuppressive therapy may be a contributing factor.

Adenocarcinoma↗