Biomedical subjects
Publications and source records attributed to A Maldonado.
This paper tries to group previous ideas related to: 1. The high possibility of metastatic disease to bone from carcinoid tumor to show a blastic pattern. 2. Cushing's syndrome can be secondary to non endocrine neoplasms. Both of these entities were present in the case being discussed which had a metastatic carcinoid but the primary site was not established.
The record and roentgen findings in a patient with Paget's disease with coexisting multiple myeloma have been presented. Their rare or even unique association is recorded to refresh ones recollection that patients with Paget's disease may be host to a second disease, which if recognized, may be of inestimable profit to the medical care and comfort of the patient.
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This article reviews the common musculoskeletal disorders that are likely to be encountered in the women's primary care setting. Basic anatomy and physiology of the musculoskeletal system are reviewed, and the assessment and treatment of complaints of strains, sprains, low back pain, chest pain, carpal tunnel syndrome, musculoskeletal pain syndrome, fibromyalgia, osteoporosis, and osteoarthritis are discussed. Examples of low-technology treatment strategies are included.
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In studying the post-mortem diagnosis of porcine proliferative enteropathy (PPE) a "double-blind" study was performed on 77 apparently healthy "finisher" pigs at the time of slaughter, to compare the results of a polymerase chain reaction (PCR) technique with those of (1) an indirect immunofluorescence assay (IFA), (2) examination for gross proliferative lesions at slaughter, (3) histopathological study of sections stained with haematoxylin and eosin (HE), and (4) Warthin-Starry (WS) silver staining for intracellular bacteria. The IFA, with a sensitivity of 89% and a specificity of 97% (positive "likelihood ratio"=30) and an agreement of 82% with PCR, is suggested as an alternative to the PCR in the post-mortem diagnosis of PPE. Histopathological examination was shown to be of little use as a principal diagnostic method, although it appeared to be effective in diagnosing infection by Lawsonia intracellularis in cases with proliferative-type lesions (positive likelihood ratio=29.6). Finally, the values obtained from an examination of gross lesions (k=0.075; positive likelihood ratio of 1.3) and WS staining (k=0.42; positive likelihood ratio of 5.3) demonstrated the lack of validity of these tests for the diagnosis of L. intracellularis infection.
The pituitary gonadotropins--luteinizing hormone and follicle-stimulating hormone--as well as the placental choriogonadotropin belong to the family of glycoprotein hormones. These structurally related hormones, which regulate several major reproductive functions of the body, are heterodimers consisting of a common alpha-subunit noncovalently bound to a beta-subunit. The N- and O-linked oligosaccharide chains of these gonadotropins play an important role in intracellular folding, assembly, secretion, metabolic clearance, and biological activity of the hormone. Gonadotropin glycosylation is a highly complex process; within the gonadotropes it is modulated by a variety of extrapituitary factors of hypothalamic and gonadal origin. In particular, estrogens and androgens appear to regulate terminal sialylation and/or sulfation of the oligosaccharide attachments and hence some functional properties of the gonadotropin molecule determined by these residues, i.e., metabolic clearance and in vivo biopotency. Through these extrapituitary inputs, the anterior pituitary may not only regulate the quantity but also the quality of the gonadotropin signal delivered to the gonads in a given physiologic or pathologic condition.
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The development of resistance in three stages throughout an active infection (pre-ovular, acute and initial chronic stages) was studied, comparing the total number of adult worms recovered from the reinfected group and the control groups. It was shown that Nectomys squamipes was unable to develop resistance in the tested conditions and, on the other hand, reinfection in the pre-ovular period of the parasite led the rodent to present the phenomenonacilitation, with reduction of natural resistance and an increase in the parasite load. These results suggest the existence of other forms of immunity diverse from the concomitant immunity in the host-parasite relationship, according to the employed model.
OBJECTIVES: To analyze the influence of bariatric surgery over nutritional status in patients with morbid obesity after 1 year of following. To know the influence of specific factors as age, sex and common channel's length. DESIGN: Retrospective study from 1998-2001. SUBJECT: All patients suffering from morbid obesity that had been operated during this period of time, 40 subjects: 28 women and 12 men with a mean age of 38 +/- 12 years old. Were studied. METHODS: We analyzed the variations of weight and other anthropometric measures, biochemical parameters and the micronutrient (vitamins A, D, E, B12, folate, C, zinc, Calcium, Magnesium) status during 1 year of following after surgery. RESULTS: Percentage weight loss was 29.7 +/- 2.9% without sex differences. A significant (p < 0.005) descent of serum cholesterol, triglycerides, and uric acid level as well as liver function markers was observed. All the hyperglycemic disturbances were reverted. 97% and 48% of the patients developed hypovitaminosis A and D respectively, that was correlated to steatorrhea. Vitamin E deficiency was found in 72% of the patients, and zinc deficiency in 68% CONCLUSIONS: Our expected weight loss 1 year after bariatric surgery is 30%, irrespective of sex and age. This loss is accompanied by a significant improvement in metabolic parameters, but the high prevalence of micronutrients deficiency that was found makes an early supplementation and close follow-in of these patients very advisable.
INTRODUCTION: Clinical nutrition is an activity realized in most of Health Centres of France, Canada, Great Britain and USA. The aim of our work was to determine activity and resources of Nutrition Units of Hospitals in the Community of Castilla y León. MATERIAL AND METHODS: A questionnaire was send to all Hospitals of Castilla y León (SACYL); Hospital Universitario Rio Hortega, Hospital Clinico Universitario, Hospital Comarcal de Medina del Campo, Hospital General Yagüe-Divino Vallés (Burgos), Complejo Hospitalario de Le6n, Hospital General de Segovia, Hospital Virgen de Sonsoles de Avila, Hospital Virgen de la Concha de Zamora, Hospital Comarcal de Aranda de Duero, Hospital Comarcal de Miranda, Hospital General de Soria, Hospital Clinico Universitario de Salamanca. RESULTS: Nine Centres responded questionnaire (75%). A total of 5 Hospitals had a Unit of Nutrition (55.6%). The results showed an average of 0.37 +/- 0.55 specialists for each 400 beds, 0.87 +/- 0.63 nurses for each 400 beds and 1.91 +/- 2.3 auxiliaries for each 400 beds, with an average of 0.21 +/- 0.41 specialists for each 100,000 habitants, 0.49 +/- 0.36 nurses for each 100,000 habitants and 1.09 +/- 1.2 auxiliaries for each 100,000 habitants. The activity of these Units is demanded by other Units, with an average of 3.2 +/- 3.4 consultations per day. The main diseases of this activity were 33.3% tumoral pathology, 55.6% surgery and 11.1% neurological pathology. Oral supplements were the first intervention tool. Only 3 Centres had a home artificial nutrition consultation. The main diseases of this activity were post surgical patients (33,3%), tumoral pathology (33,3%), neurological pathology (22%) and inflammatory bowel disease (11%). CONCLUSION: Resources in Units of Nutrition of Castilla y Leon were limited. However, activity in Hospital an in home is equal than other areas. New actions of Local Administration are necessaries to follow recommendations of Council of Europe.
This study showed how often oxygen desaturation occurred in patients undergoing upper endoscopy procedures; extent of desaturation after sedation with diazepam, relationship between desaturation and respiratory function status and compared two types of instruments Olympus (XQ, K10). Ninety nine patients undergoing elective and emergency upper endoscopy procedures were monitorized with pulse oximeter before sedation, during and after the procedure. We did not find any change clinically significant.
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A serological survey was performed in the Guadalquivir Marshes (Southern Spain) in order to determine the presence and diffusion of six infective agents in wild waterfowl. The analysis covered 712 waterfowl from 13 species belonging to five taxa (Podicipediformes, Ciconiiformes, Anseriformes, Gruiformes, and Charadriiformes). A range of immunological techniques led to detection of antibodies against the six infective agents studied: Chlamydia psittaci (13.3%), Mycoplasma anatis (3.5%), Pasteurella anatipestifer (2.9%), duck plague virus (1.6%), Aspergillus fumigatus (1.1%), and Newcastle disease virus (NDV) (0.2%). The survey results indicated that these infective agents exist and circulate among wild waterfowl in the Guadalquivir Marshes.
The administration of full doses of chemotherapy according to an established schedule improves the response rate and duration of response in cancer patients. However, frequently there are delays in therapy due to dose-limiting side effects and chemotherapy could affect permanently normal tissues. This has led to the development of chemotherapy protectors and of rescue agents in the past years. We will discuss some of these new agents and their use in cancer treatment. Some of these agents include amifostine (Ethyol), dexrazoxane (Zinecard), mesna (Mesnex), leucovorin, G-CSF, GM CSF, recombinant erythropoietin and thrombopoietin. Oncologists must learn the adequate use of different strategies in reducing chemotherapy toxicity in order to improve both the quality and quantity of life of cancer patients.