[76 year old male with polymyalgia and halo sign].
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to C Richart Jurado.
Explore the source record for details and available documents.
OBJECTIVES: To assess the routine indication of chest roentgenogram after thoracentesis in function of iatrogenic pneumothorax causation, following a procedure protocol. PATIENTS AND METHODS: Prospective study of 104 consecutive thoracentesis procedures performed in 76 patients. The procedure was protocolized and after each thoracentesis a chest roentgenogram was obtained within 6 hours after the procedure. The attending physician completed a questionnaire relative to patients data characteristics of the pleural effusion. RESULTS: Two pneumothorax were noted following thoracentesis (2%) which did not require pleural drainage. These pneumothorax occurred in patients with parapneumonic pleural effusions. CONCLUSIONS: The routine practice of chest roentgenogram after thoracentesis does not seem to be warranted and should be individualized. The performance of thoracentesis by physicians in training period, with procedure protocolization, minimizes the risk of pneumothorax.
When faced with a patient with exercise-induced syncope, it is important to exclude heart disease. Nevertheless, neurally-mediated syncopes should be taken into account in the differential diagnosis and the tilt table test is essential to establish this diagnosis. We report the case of an 11-year-old boy, who presented recurrent exercise-induced fainting. The results of cardiac and neurologic tests were negative. The tilt table test with pharmacological challenge with isoproterenol infusion induced arterial hypotension and presyncope, and a diagnosis of neurally-mediated syncope was made. After initiating beta-blocker treatment, the patient has remained asymptomatic during a follow-up of 10 months.
Explore the source record for details and available documents.
OBJECTIVE: To analyze which genotypes of vitamin D receptor (VDR) are associated with the loss or maintenance of bone mass among spanish postmenopausal women. MATERIAL AND METHODS: A total of 105 women with postmenopausal osteoporosis and 51 postmenopausal women without osteoporosis (control group), diagnosed with bone densitometry (DEXA) were included in the study. The genetic locus was analyzed with RFLP by using the restriction enzyme BsmI. The obtained polymorphism was correlated with clinical, densitometric and metabolic parameters (including bone turnover markers). RESULTS: Two alleles were obtained with three bands of different size: one 580-570 bp band corresponding to allele B, and two 405-400 and 175-170 bp bands for allele b. None of the three VDR genotypes (BB, bb, Bb) was significantly associated with a higher or lower bone mass among the studied populations. Likewise, in the group of patients with osteoporosis no genotype was associated with bone mineral density (BMD) values or with bone turnover parameters analyzed. No differences were found between subgroups with non-severe (n = 58) and severe (n = 47) osteoporosis regarding the association with any of the three VDR genotypes. CONCLUSIONS: None of the VDR genotypes was associated with BMD loss or with the activity of bone turnover parameters analyzed in a group of spanish women with postmenopausal osteoporosis. None of the VDR genotypes confers a higher susceptibility to suffer from severe osteoporosis.
Explore the source record for details and available documents.
A 44 year-old man with a type I Neurofibromatosis (NFI) and an intercostal mass is presented. By means of percutaneous fine needle aspiration punction under CT control, this tumor could be diagnosed of neurofibroma. It is important to remark not only the role of helical CT with anatomical reconstruction in the diagnosis of intercostal tumors, but also that intercostal location of neurofibromas has been rarely reported in the literature. Because of frequent association between NFI and neoplasms, it is always necessary to perform histological study of every new tumor that appears in the course of this entity.
In order to determine the changes in the clinico-pathological pattern of admitted patients in an internal medicine department, 240 patients/year were compared during the years 1984 and 1989. A predominant proportion of males was registered (3:2); which did not vary by the year. An increased tendency of the median age (55.78 vs 58.48 years) was also established. The medium time of admission (8.98 vs 9.5 days) and mortality rate (6.3% vs 7.1%) did not change. A high rate (greater than 50%) of cardiovascular and respiratory disease was found on analyzing the cause of admission; in 1989 infection caused by HIV was detected and admissions to optimize the treatment of patients with diabetes mellitus were observed which did not exist in 1984. A slight but surprising decrease in admissions due to acute ischemic cardiopathy and significant decrease of admissions owing to respiratory disease were also noted. The majority of the patients admitted had a baseline disease (85% in 1984 and 87.1% in 1989). The knowledge of these data and their variations in every hospital department will, undoubtedly, assist in achieving a better use of technical and human health resources.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.