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Biomedical subjects

A M Alonso

Publications and source records attributed to A M Alonso.

At least 19 recordsLinked to original sources
PubMed2004

Contrast-enhanced sonography during uterine artery embolization for the treatment of leiomyomas.

Uterine artery embolization (UAE) is a successful and safe treatment for symptomatic leiomyomas. However, rare complications such as premature menopause and uterine necrosis can arise because of embolization of non-target tissues. We studied the feasibility of using contrast-enhanced sonography with intravenous SonoVue just before, during and after complete occlusion of both uterine arteries. In a patient with multiple, large, symptomatic leiomyomas, contrast-enhanced imaging established that the UAE was technically successful and that myometrial vascularity was not reduced. Our case suggests that ultrasound contrast agents may have a role in monitoring UAE and thus may help prevent ischemic complications. Further studies are required to confirm this.

Arteries↗
PubMed2003

[Prospective clinical and sonographic assessment of uterine artery embolization as the treatment of symptomatic uterine leiomyomata].

OBJECTIVE: To evaluate the effectiveness of the uterine artery embolization as the treatment of symptomatic uterine leiomyomata. PATIENTS AND METHODS: Eighty-five women with symptoms caused by uterine leiomyomata underwent uterine artery embolization as an alternative to surgery from january 1997 to june 2000. The effectiveness of this method was evaluated by clinical and sonographic examination. RESULTS: The recession average was of 18.9 months. There were ten failures. We had immediate failures (n = 5) with a case of technical failure, one endometrium cancer, one adenomyosis, one larger subserosal leiomyomata and one parametrial leiomyomata. We had recurrences (n = 5) with the occurrence of new leiomyomatas (1 intramural and 3 submucosal) and an evolution of previous leiomyomata. The average volume reduction was 51% for the uterus and 65% for the main fibroid at one year follow-up. Minor complications occurred in 5%. Permanent amenorrhoea was observed for 3.75% of the women. Using cox model, no predictive factors of embolisation effectiveness were found. DISCUSSION AND CONCLUSION: In the treatment of symptomatic uterine leiomyoma, uterine artery embolization is an effective alternative to surgery. After one year and half, we had 12.5% of failures.

Adult↗
PubMed2000

Familial choanal atresia with maxillary hypoplasia, prognathism, and hypodontia.

We report on two sibs and a cousin with bilateral choanal atresia. At 2 months, one sib died of complications following surgical correction of her defects. We evaluated her brother and cousin at age 7 and 9 years, respectively. Both had a tall forehead, maxillary hypoplasia, prognathism, and absence of certain deciduous and permanent teeth. Psychomotor development was appropriate for age. Roentgenocephalometric analyses of several relatives showed that one grandfather of these children and two of the five uncles and aunts also had maxillary hypoplasia and/or prognathism. To our knowledge, this condition has not been described previously and may represent a newly recognized autosomal dominant condition with incomplete penetrance and variable expressivity caused by a defect of neural crest development.

Adult↗
PubMed2000

[Guidelines of the Spanish Society of Cardiology for clinical practice in exercise testing].

Most exercise testing is performed in adults with known or suspected ischemic heart disease. In the last few years cardiac imaging techniques have been applied in this field, improving the information obtained with the procedure. However, the exceptions to this rule are emerging rapidly not only in healthy people (asymptomatic individuals, athletes, handicapped people) but also in cardiac patients (advanced congestive heart failure, hypertension, rhythm disorders, congenital heart disease, etc.). All the-se issues justify the need for a multidisciplinary consensus document in Spain. This paper reviews and updates the methodological aspects of the stress test, including those related to oxygen consumption measurements. The main aim of this review was to determine the role of exercise testing in the evaluation of ischemic heart disease as well as the applications of imaging stress testing. The usefulness of this test in other non-ischemic cardiac disorders and in selected subsets of healthy people is also reviewed.

Adult↗
PubMed2000

[Guidelines of the Spanish Society of Cardiology on valve heart disease].

Valvular heart diseases, which continue to be a major cause of morbidity and mortality world wide, have undergone radical changes since the first valve prostheses were implanted 40 years ago. These changes have been the result of both scientific progress and improved standard of living in developed countries. The availability of penicillin to treat streptococcal pharyngitis and less crowded living conditions have now made rheumatic fever uncommon in these countries. However, other forms of valve impairment have appeared over the past several years. The etiology of some of these valvular diseases remains obscure (e. g. myxomatous mitral valve); others, such as the senile type of calcific aortic valve stenosis, seem to be the price to be paid for the extension of life expectancy. With regard to diagnosis, echocardiography has constituted a formidable tool for visualizing anatomic valve changes, interpreting complex hemodynamic derangements, and evaluating repercussion on the left ventricle. In addition, the iteration of this non-invasive examination has allowed a much better understanding of the natural history of non-severe valvular disease and therefore of the precise timing for surgical intervention, without awaiting, in most cases, the appearance of advanced symptomatology. This has also been possible because of the great advances in cardiac surgery which can be summarised as: a) the improvement in extracorporeal circulation and myocardial preservation techniques; b) the greatly improved biologic and mechanic valve substitutes; c) the introduction of imaginative mitral valve repair procedures, and d) the use of intraoperative transesophageal echocardiography to assess the adequacy of valve repair. At the same time, percutaneous catheter balloon valvuloplasty has emerged as a valid alternative to mitral surgical commissurotomy for mitral stenosis. All these changes, and many more that can not be described in this brief summary, make a review of the management of patients with valve heart disease appropriate.

Cardiology↗
PubMed1999

[Varicella pneumonia during pregnancy after double exposure in the 2nd trimester. Value of seroprophylaxis].

We report on a case of varicella pneumonia at 29 weeks of gestation after double contact during the second trimester of pregnancy although passive immunotherapy by polyvalent immunoglobulins was used. Our case report highlights the difficulties of varicella pneumonia diagnosis that was here confirmed by seroconversion and the presence of pathognomonic microcalcifications, on a pulmonary X-ray, realized two years after pregnancy. Although the absence of publications asserting the efficacy of immunotherapy by polyvalent immunoglobulins to prevent maternal complications of varicella during pregnancy, they remain widely employed in such cases. Our point of view is that this indication must be revisited.

Adult↗
PubMed1997

Case report and review of the literature: primary twin ovarian pregnancy.

A case report of primary twin ovarian pregnancy is presented. A 36 year old woman, gravida 4 para 3, was admitted to the hospital for suspected ectopic pregnancy, with vaginal bleeding at 11 weeks after her last menstrual period, associated with pelvic pain. An endovaginal ultrasonography led to the diagnosis of twin ovarian right ectopic pregnancy with two dead fetuses associated with a compartmentalized haemoperitoneum. Unilateral oophorectomy was carried out by laparotomy. Histological studies confirmed an uni-ovular di-amniotic ovarian pregnancy. Seven cases of ovarian twin pregnancies are reviewed in the literature. This case is the first one where diagnosis has been made by endovaginal sonography.

Adult↗
PubMed1995

Repair of radiation-induced vesicovaginal fistula with a rectus abdominis myocutaneous flap.

The cutaneous RAM flap was used successfully to repair a radiation-induced vesicovaginal fistula. Patient selection is important, ideally one with a fatty lower abdominal wall and without a previous incision transecting the inferior rectus muscle below the umbilicus. The RAM flap has excellent vascularity, allows augmentation of the bladder, and permits an extraperitoneal approach, factors that are important when operating in an irradiated field.

Cystoscopy↗
PubMed1995

A computer system for epidemiological surveillance.

In epidemiological surveillance, it is imperative that any unusual increase in reported cases be detected as quickly as possible. In the surveillance unit at "Pedro Kourí," it was necessary to create a computer system for the surveillance of transmissible diseases in order to manage such variables as morbidity, mortality, and the circulation of causal agents. As usage flexibility is a fundamental requirement, we developed VIGILA as a system readily adaptable to any level of the country's health organizations (national, provincial, or municipal). VIGILA permits the storage, validation, and statistical analysis of morbidity and mortality data, and it also allows the user to apply these features to causal agent information. These manipulations are all performed in the context of a specific transmissible disease. The stored information can be displayed in different types of statistical formats, such as calculated rates, accumulates and medians. The user can also design his/her own tables for display. In addition, the program offers graphics that depict the endemic forecast for a specific region and age group. Reliable forecasts based on temporal models of an epidemiological indicator are necessary for the prediction of the non-epidemic indicator and for the elaboration of an alert threshold. The endemic forecast or endemic channel is calculated by means of a modified version of R. Serfling's model [1] which adapts to data series with stationary characteristics. In this case, the model is fixed for the medical attention protocol and the circulation of agents of a specific transmissible disease. The parameters of the model are estimated by the least square method. The confidence limits are calculated with the T-Student distribution [2]. To enter information about a specific disease and level of health concern, the user must define the disease under analysis, the principal territory under surveillance and its dependencies, the causal agents of the disease, and the frequency with which the disease is reported. This system stores the number of cases (morbidity) and death (mortality) that occurred in the territories and age groups defined during entry. To facilitate the calculation of morbidity and mortality rates, information pertaining to the number of territory habitants and their age groups is also stored. The laboratory data includes the number of analyzed samples in the territories and age groups defined in the data entry, and the samples that were positive to the defined agents. Among the principal uses of the system are: calculation of cumulative cases, rates, and cumulative rates for the specific period of analysis, territory, and age group; comparison of these health indicators with the previous year's indicators or with the median of the previous years' indicators' calculation of the endemic forecast that permits the user to observe the epidemiological situation by territories and age groups; and the early detection of an increase in disease occurrence. The system also offers a geographical representation of the epidemiological situation in the territories, showing a map with the evaluation of each territory with respect to four possible risk factors. VIGILA is available in both DOS and WINDOWS 3.1 formats. This system allows the evaluation of the situation at a specific point in time in the analyzed territories, and may alert the infection control team to an epidemic early enough to allow implementation of control measures.

Computer Systems↗
PubMed1981

[Sézary-Baccaredda syndrome].

One case of Sezary Syndrome is presented and studied from the clinical, histopathological and hematological point of view. Clinically the patient presented besides keratodermia on the palms and a severe pruritus, an erythrodermia of very ostensive redness, like the so-called Hallopeau's red man. On the skin, by histological examination, it was observed an infiltration with some round cells, whose nucleus were hyperchromatic and irregular, as it is to be seen in the Sezary's cells. A lymph node taken from the cervical region did not show any specific infiltrate but only a dermopathic adenopathy. Lymphoid cells of folded nucleus were revealed by the hemogram, quite suggestive of Sezary's lymphoma. In the marrow, the normal cells kept on their regular proportion, but some abnormal and invasive ones stand out with their convoluted nucleus, quite suggestive of Sezary's cells. These typical Sezary's cells have been found in the skin lesions, in the blood and in the marrow. The possible origin--in the skin or in the lymph nodes, but not in the marrow--of such cells is put to a summarized discussion. Finally, the Sezary's Syndrome may be an erythrodermic or leukemic variant of "morbus fungoide". Treatment on the basis of MOPP and CHOP methods with Bleomycin association has been attempted but, so far, the results have not been satisfactory in spite of an 18 month treatment.

Antineoplastic Agents↗
PubMed1981

[Albopapuloid epidermolysis bullosa (Pasini's disease)].

The aim for this communication is one case of the dystrophic Epidermolysis bullosa in its variant just called as "albopapuloid". The patient a male of 25 years, suffers from the disease since the age of 2. His mother and one brother show the same disease. The clinical manifestations began as bulloe on the superior and inferior limbs. The bullae heal with atrophic scars and the eruption is constantly relapsing after subsiding. Besides the bullous eruption there are other lesions persistently coming out as whitish elevations which are elongate as to form numerous streaks on the surface of the skin. Such lesions started at the age of 5 and do not come from the bullae but they are quite independent, and constitute the essential characteristic for the albopapuloid clinical variant. Small miliary epidermal cysts are seen over the scars. Dystrophic changes of the nails with absence of many of them and the toes show the lst phalanges partially absorbed. On histological examination the bullae are subepidermal and contain a fibrin-leukocytic exudate. The albopapuloid lesions reveal keratosis, epithelial atrophy, diffuse and condensed fibrosis in the corium and around the hair follicles.

Adult↗
PubMed1975

[Reactional status of leprosy].

Reactional leprosy is studied according to its clinical forms A) Lepromatous a) Acute lepromatization: encroaching and invasive nature; the patient becomes more and more lepromatous ; bad prognosis. b) Erythema nodosum: "contusiform dermatitis"; variable prognosis not so bad as it is in the preceding case; allergic nature and its evolution is usually detained and therapeutics efficient. c) Erythema multiform. d) Lucio's phenomenon: vascular lesions and consequently necrosis as a complication of the "erythema necrotisans" (beautiful leprosy). B) Tuberculoid Reactional tuberculoid is the only one in this benign type, the Mitsuda's test must always be positive and prognosis consequently good. C) Dimorphous or "Borderline" whose Mitsuda's test is mostly negative, sometimes positive, but not stable. The lesions may stimulate the tuberculoid leprids but they invade mucous membranes, are impregnated by pigmentation, may present the Unna's band, and other characteristics of the Lepromatous type. Are associated (fever, asthenia and emaciation). Prognosis not very good, because of the possibility of lepromatization, according to its tendency. Evolution slower and frequent relapses. Besides there are nodular lesions. Pathogeny 1) Perifocal allergic reaction (Jadassohn). Similar to epituberculosis and Herxheimer reaction. 2) Septicemia. Sensitized tissues inside or outside the lesions, are invaded by the bacilli and so the allergic reaction takes place. Even without culture resources, Mycobacterium leprae has been found in the blood by direct examination. 3) Autoimmunization (Waldenstrom, Matthews and Trantman, 1965). Based upon the similarity between both humoral syndromes, in leprosy reactions and collagenous, diseases, as to: hypergammaglobulins, hypercryoproteins, antigammaglobulins, serological reactions (Wassermann, Kahn, Kline, VDRL) positives, Antistreptolysin O, protein C reactive, antinuclear factors, latex and Wadler-Rose test positives (rheumatoid tests) lowering of complement. If leprosy reaction is like this, it should be the less agressive of the autoimmune diseases. a) Its eruptions are cyclic not of long standing duration, as a general rule. b) Its prognosis has been recognized as good, except lately, because of the use of corticoid therapy which has been fatal, in many cases. After some years the leprosy reaction cures spontaneously. Treatment (see article)

Erythema Multiforme↗