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C Llorente

Publications and source records attributed to C Llorente.

At least 19 recordsLinked to original sources
PubMed1997

Application of self-expanding stents in prostate cancer with rectal involvement. Report of two cases and review of the literature.

OBJECTIVES: Rectal involvement due to local spread from prostate cancer is an uncommon finding. When this condition occurs, prognosis is ominous. Our objective is to report our experience in the use of self-expanding endorectal stents in the management of rectal invasion from prostate cancer. Two cases are presented and a review of the literature is carried out. METHODS AND RESULTS: In both cases, self-expanding Wallstent devices were placed (under fluoroscopic control), in order to solve their episodes of bowel obstruction. It was successfully performed in both patients. Therefore, an open surgery procedure was avoided. CONCLUSIONS: When facing the evidence of a tumor that invades the rectal wall, it is important to rule out the existence of prostate cancer (the surgical option in these patients carries an ominous prognosis). Therefore, we propose this new procedure whose results could be very satisfactory in certain settings.

Aged↗
PubMed1994

Effects of halothane and isoflurane on ventilation and occlusion pressure.

BACKGROUND: Isoflurane has been said to be more ventilatory depressant than halothane. However, data for comparing the respiratory effects of halothane and isoflurane in humans are insufficient at this time. The aim of this study was to extend our understanding of the nature of the central, as opposed to peripheral, ventilatory effect of halothane and isoflurane by comparing them at two concentrations. METHODS: Twenty patients were randomly assigned to receive halothane (n = 10) or isoflurane (n = 10). The patients were studied the day before surgery and during anesthesia immediately before surgery. Ventilatory effects were analyzed in terms of breathing pattern, end-tidal carbon dioxide pressure (PETCO2) and inspiratory occlusion pressure. After anesthetic induction and orotracheal intubation with thiopental and succinylcholine patients were allowed to breathe halothane or isoflurane in oxygen spontaneously at 1.2 (low) and 2.0 (high) minimum alveolar concentration (MAC) applied in random order. Inspiratory active impedance during anesthesia was also measured. RESULTS: Significant reduction of minute ventilation between awake and low MAC states was observed for isoflurane (-34.4%; P < 0.001) but not for halothane. Inspiratory occlusion pressure at 100 ms increased significantly between awake and low MAC states, from 1.43 +/- 0.89 to 2.67 +/- 1.05 cmH2O (P < 0.05) for halothane, representing an 87% increase, whereas a nonsignificant increase (16%) was observed for isoflurane. Both anesthetics showed a dose-related ventilatory depressant effect, not attributable to changes in mechanical properties, reflected by significant reductions in minute ventilation (P < 0.001), tidal volume (P < 0.001), and inspiratory occlusion pressure at 100 ms (P < 0.05) and increases in respiratory rate (P < 0.001) and end-tidal carbon dioxide pressure (P < 0.01) when concentration was increased. However, at the higher concentration a significantly greater reduction of minute ventilation (P < 0.01) was observed for isoflurane (-25.6%) than for halothane (-9.4%). We did not observe differences in respiratory rate between the two anesthetics. Significant differences in inspiratory occlusion pressure wave were observed, characterized by a concave-upward tendency for isoflurane and for high concentration. CONCLUSIONS: Our study confirms the stronger ventilatory depression induced by isoflurane compared with that induced by halothane and indicates that halothane at 1.2 MAC induces significantly less ventilatory depression than expected.

Adult↗
PubMed1990

Vasopressin/nitroglycerin infusion vs. esophageal tamponade in the treatment of acute variceal bleeding: a randomized controlled trial.

Vasopressin infusion and esophageal tamponade are still widely used to arrest variceal bleeding, but no objective evidence exists on the superiority of either of the two procedures. In this study, 108 cirrhotic patients bleeding from varices were included in a prospective, randomized trial to investigate the comparative effectiveness and safety of balloon tamponade (using the Sengstaken-Blakemore tube for esophageal varices and the Linton-Nachlas tube for gastric varices) (n = 52) and intravenous vasopressin infusion (0.4 to 0.8 mu/min) plus intravenous nitroglycerin infusion (40 to 400 micrograms/min) (n = 56). Both treatments were maintained for 24-hr. The hemostatic efficacy according to the intention to treat was 86.5% for tamponade and 66% for pharmacological therapy (p less than 0.01). No significant differences were found with respect to rebleeding during the first 72 hr after treatment, mortality rate or side effects. These results suggest that esophageal tamponade is more effective than vasopressin/nitroglycerin infusion in the treatment of variceal bleeding in cirrhotic patients.

Acute Disease↗
PubMed1989

[Emergency endoscopic sclerosis in active hemorrhage caused by esophageal varices: analysis of 31 cases].

We have reviewed our experience in urgent endoscopic sclerosis of bleeding esophageal veins in most patients (67.7%) secondary to alcoholic liver cirrhosis. Through the flexible gastroscope, 1% of polydocanol was injected intra and periveinaly for sclerosis. Initial and primary hemostasis was achieved in 90.3% and 87% of the cases respectively. Hemorrhage recurred in 14.2% of the patients. Hospital mortality was 38.7% (11 patients classified in Childs group C and 1 patient in group B), although only 19.3% of the patients died because of esophageal vein bleeding. These results suggest that in a satisfactory percentage of cases urgent sclerosis of esophageal veins controls active bleeding, and the hospital mortality depends mainly on the severeness of liver failure in these patients.

Adult↗
PubMed1985

New location of milk-of-calcium.

A case of milk-of-calcium with an exceptional location is reported. The characteristics of milk-of-calcium are presented, with stasis and urinary tract infection being the most important etiologic factors in this case. Structurally the stones are formed by a central core of calcium phosphate surrounded by magnesium-ammonium phosphate (struvite).

Adult↗
PubMed1984

Bone lithiasis or bone metaplasia?

A case in which bone has been found in the upper urinary tract is reported. Since the physiopathology and morphological characteristics of this tissue do not meet the requirements needed to be defined as a urolith, we believe this is a case of bone metaplasia and not urinary lithiasis.

Adult↗
PubMedDate not supplied

[Deferred repair of surgical ureteral lesions].

Our experience in surgical injuries of the ureter, as well as the therapeutic approach followed to repair them as expounded in this paper. Immediate nephrostomy following diagnosis, and restoration deferred a minimum of three weeks have provided good results, as well as it has allowed us to detect and achieve spontaneous restoration in one case. These reasons, together with the absence of technical difficulties during the second intervention, invite us to consider the reevaluation and deferred restoration--if appropriate--of the surgical ureteral injuries as a therapeutic approach from which a number of patients can profit.

Female↗
PubMedDate not supplied

[Usefulness of blood specimens on paper strips for serologic studies with inhibition ELISA].

To evaluate the usefullness of the collecting method of blood samples in filter paper strips for anti-dengue antibody detection using an ELISA Inhibition test which has been recently developed in our laboratory, blood samples collected on filter paper strips and serum samples were obtained from the same blood donors. Both samples were kept at -20 degrees C and tested at 15 days, 3 and 6 months. Titers were determined in positive samples. Comparing the results, no significant differences were found between serum samples and blood samples collected in filter paper strips in relation to the number of negative and positive cases. Nevertheless, it was observed in both types of samples a decrease of the antibody titers (one dilution) in the longest period of our study (6 months).

Antibodies, Viral↗
PubMedDate not supplied

[Comparison of thiopental and propofol in short-duration anesthesia].

Forty healthy females, 18 to 65 years, undergoing diagnostic or therapeutic uterine curettage were studied with the purpose of comparing anesthetic characteristics of thiopental and propofol as induction agents. They were randomly allocated in two groups: A propofol induction group (2.5 mg/kg), and a thiopental induction group (4-5 mg/kg). Fentanyl (2 micrograms/kg), was administered 2 minutes before anaesthesia, and N2O/O2 (66%/33%) by mask was maintained during surgery. Changes in systolic and diastolic BP were not significantly different in two groups. The HR decreased more significantly in the propofol group (20% vs 10%; p less than 0.005). Apnea was significantly greater in the propofol group, in term of incidence (50% vs 15%; p = 0.025), and duration (92 seg vs 17 seg; p = 0.20). The lapses of time to opening the eyes and response to a command were not significantly different, but the time to be able to seat was significantly lower in the propofol group (12 min vs 21 min; p = 0.0003). Anaesthesia was clinically satisfactory for most patients in both treatment groups.

Adolescent↗
PubMedDate not supplied

[Pubo-vaginal percutaneous suspension by the Gittes technique for stress incontinence. Initial experience].

The paper presents our initial experience with endoscopic suspension of the vesical neck, as per the modification introduced by Gittes and based on incorporation through the vaginal mucosa of non-absorbable single-filament sutures. In this way it is feasible to use a simple non-incisive vaginal surgery with minimum morbidity. Good results have been obtained so far in six of the seven patients operated on. No complications have presented following tube retrieval on the second day. It is our belief that these initial results can be a reasonable basis to a wider use of this technique and to know its long-term results in treating stress incontinency through urethral hypermobility.

Endoscopy↗
PubMedDate not supplied

[Value of cavernous gasometry in the physiopathologic diagnosis and treatment of priapism].

Currently, each case of priapism therapy must be customized depending on the patient's individual pathophysiology. To this end, in addition to anamnesis and the macroscopic aspect of the suctioned blood, quantification of existing ischaemia by cavernous gasometry is quite important. This will make possible the distinction between two types of priapism: ischaemic, vein-occlusive or low-flow; and nonischaemic, arterial or high-flow. Each of these priapism types presents a clearly different mechanism of production and, more importantly, a different response to the various therapeutic options currently available. The ischaemic form responds to suction-washing procedures and to the various techniques of vein by-pass. On the contrary, these manoeuvres will be useless in non-ischaemic or arterial priapism, where alpha-adrenergic injections or lacerated artery embolization should to be used.

Adult↗
PubMedDate not supplied

[Incidental carcinoma of the kidney with renal vein thrombosis].

Incidental carcinoma of kidney is an increasingly common pathology as a result of a wider use of high resolution diagnostic methods. The special characteristics of these tumors, usually small and in a low grade or stage, make conservative surgery to be considered as a valid therapeutical option. An incidental carcinoma of kidney with tumoral thrombosis of the renal vein undetected in the pre-surgical study, circumstance which allows to emphasize the malignant potential of these tumors is presented here. Based on this, we believe that a meticulous evaluation of the renal vein condition should be made, in patients considered as possible candidates for conservative surgery. In this sense, selective renal phebography and magnetic resonance could be considered explorative means that play an important role in the introduction of renal preservation surgery, if future studies show that its use allows an early detection of the tumoral condition of renal vein.

Adenocarcinoma↗