[Recurrent urinary tract infection in girls: developmental analysis of 39 cases. Preliminary summary].
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Bacterial Infections↗
Biomedical subjects
E Guerra
Publications and source records attributed to E Guerra.
El hospital invisible. A study of Curanderismo.
This report presents the results of interviews with 16 Mexican-American folk healers (curanderos and curanderas) in San Antonio, Tex. Curanderismo was found to be alive and well in San Antonio, though its practitioners tend to be older and its future unclear. Several salient characteristics of the practitioners were clarified such as the process of becoming a healer, referral practices, types of disorders treated, and treatment of the traditional folk illnesses. We take a basically conservative position on whether curanderos can ever be incorporated into the health care delivery system. However, this study confirms that the practitioners and their clients simultaneously utilize the folk medical system and the scientific medical system.
Adult↗
Labile and stable glycosylated hemoglobin during OGTT in healthy subjects and maturity-onset diabetics.
HbA1 levels were determined by a rapid chromatographic column test in 15 healthy subjects (HS) and in 15 maturity-onset diabetics (MOD), fasting and 2 h after glucose ingestion (100 g for HS, 50 g for MOD). Chromatography was carried out both before and after 6 h of red cell incubation in saline at 37 degrees C. HbA1 in HS at 0 and 120 min of OGTT was not significantly different, either before (6.24 +/- 0.61% and 6.22 +/- 0.62%) or after red cell incubation in saline (5.85 +/- 0.61% and 5.87 +/- 0.55%). Red cell incubation in saline significantly reduced HbA1 levels both at 0 and 120 min (2p less than 0.001). HbA1 in MOD before red cell incubation in saline, was slightly but significantly higher at 120 min (8.61 +/- 1.03%) than at 0 min (8.39 +/- 1.01%): 2p less than 0.001. After incubation in saline, this difference was cancelled (7.86 +/- 0.85% at 0 min and 7.97 +/- 0.83% at 120 min: n.s.). Post-incubation levels were lower than pre-incubation ones both at 0 and 120 min (2p less than 0.001). The HbA1 increment observed in MOD is significantly correlated (p less than 0.01; r=0.64) to the blood glucose increment observed at the glycemic peak. We conclude that hemoglobin glycosylation may show rapid changes also in MOD, reflecting blood glucose changes, whereas in HS the physiological glycemic excursions are not wide enough to produce rapid HbA1 changes. Since labile and stable HbA1 co-elute in the rapid chromatographic methods, red cell incubation in saline for 6 h at 37 degrees C is recommended as a simple procedure which allows the measurement of the stable fraction alone, i.e. the real index of long-term glycemic control, independent of rapid glycemic fluctuations.
Adult↗
Prognostic value of mutations in TP53 and RAS genes in breast cancer.
The identification of molecular indicators of higher risk for specific subgroups of cancer patients may allow to develop more aggressive therapeutic strategies aimed at cases with the highest likelihood of response. This would avoid unnecessary toxicity to patients and alleviate the burden of cancer care for healthcare systems. Activated oncogenes and mutated tumor suppressor genes are causal determinants of the appearance and progression of tumors in man. They therefore represent potential indicators of prognosis and/or response to therapy. However, even in cases of well-studied oncogenes and tumor suppressor genes such as TP53 and RAS, their attributed prognostic and predictive value is often based on studies of insufficient statistical power that often lead to conflicting conclusions. Findings in favor or against the use of TP53 and RAS as prognostic and predictive indicators in breast cancer are reviewed and discussed here.
Animals↗
[A multidisciplinary approach to the management of cerebral vascular malformations].
INTRODUCTION: Cerebral vascular malformations (CVM) are a heterogeneous group of lesions. One way of classifying them is according to histological criteria, clinical features, imaging findings, electroencephalography and distinctive pathology. OBJECTIVES: To report the results obtained in 16 patients clinically diagnosed as having CVM and operated on in the Centro Internacional de Restauración Neurológica (La Habana, Cuba) between March 1995 and October 1998. We also consider the usefulness of diagnostic tools for neurosurgical management and anatomo-pathological diagnosis. PATIENTS AND METHODS: We review the clinical findings, images, electroencephalograms and diagnostic histology of 16 patients. The gender distribution was 10 men and 6 women who were aged between 9 and 48 years. Stereotaxic resection guided by CAT and angiography was done in all cases. RESULTS: The predominant symptoms were headache and generalized tonic-clonic convulsions. CAT and angiography were helpful in determining the clinical diagnosis and location. The most frequent electroencephalographic finding was focal slowing associated with inactive epileptiform disorders. Histological study showed that there were 3 cases of arteriovenous malformations (AVM), one angioma cavernosa and one mixed vascular malformation (AVM plus angioma cavernosa). The malformation was not resected (it was treated with a clip) in the remaining case. CONCLUSION: Our results show the importance of structural imaging studies and their relationship to functional studies in the presumptive diagnosis of CVM corroborated by post-operative histological diagnosis.
Adolescent↗
[An automatic system for anatomophysiological correlation in three planes simultaneously during functional neurosurgery].
INTRODUCTION: The Neurosurgical Deep Recording System (NDRS) using a personal computer takes the place of complex electronic equipment for recording and processing deep cerebral electrical activity, as a guide in stereotaxic functional neurosurgery. It also permits increased possibilities of presenting information in direct graphic form with automatic management and sufficient flexibility to implement different analyses. OBJECTIVE: This paper describes the possibilities of automatic simultaneous graphic representation in three almost orthogonal planes, available with the new 5.1 version of NDRS so as to facilitate the analysis of anatomophysiological correlation in the localization of deep structures of the brain during minimal access surgery. MATERIAL AND METHODS: This new version can automatically show the spatial behaviour of signals registered throughout the path of the electrode inside the brain, superimposed simultaneously on sagittal, coronal and axial sections of an anatomical atlas of the brain, after adjusting the scale automatically according to the dimensions of the brain of each individual patient. This may also be shown in a tridimensional representation of the different planes themselves intercepting. RESULTS: The NDRS system has been successfully used in Spain and Cuba in over 300 functional neurosurgery operations. The new version further facilitates analysis of spatial anatomophysiological correlation for the localization of brain structures. CONCLUSION: This system has contributed to increase the precision and safety in selecting surgical targets in the control of Parkinson s disease and other disorders of movement.
Brain↗
Hip arthroplasty after femoral osteotomy.
The authors report the results of 56 prosthetic implants on previous femoral osteotomy. The cases submitted to surgery, some time after the operation, present with clinical-radiographic results (movement and risk of loosening) that are worse than those cases that had not undergone osteotomy. Among complications, a higher incidence of intraoperative fractures and nerve paralysis were observed. Fractures always occurred when instrumentation was removed during the same prosthetic implantation procedure.
Adolescent↗
Molecular prognostic indicators for breast cancer.
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Apoptosis↗
Cementless hip arthroplasty with a modular neck.
The authors report the preliminary results obtained in 347 prosthetic implants with hip arthroplasty with a modular neck. The advantages to using this method are related to the chance to adapt to different anatomical conditions: in particular, in primary arthroplasty a straight neck was used in the majority of cases (83%), while in dysplastic hips a straight neck was used in 47.5% of cases and a retroverse neck (8 degrees or 15 degrees) overall in 40% of cases.
Adolescent↗
The use of extra-long stems in total hip reimplantation.
The authors report their experience in the use of extra-long stems for total hip reimplantations, and they then compare them with the results obtained when short or standard stems were used. The use of the extra-long stem is reserved for special cases, such as those where there is osteolysis extending to the proximal femur and diaphysis, distal diaphyseal fractures, and when the trans-femoral technique is used to remove the stem. A total of 246 prosthetic stem reimplantations were carried out between 1985 and 1999, and in most of the cases (86.2%) the cause of reimplantation was aseptic loosening of the stem alone or of both prosthetic components, while in the remaining cases it involved the sequelae of endoprosthesis or cotyloiditis (8.5%), the sequelae of septic explantation (2.1%), breakage of the prosthetic head and cone wear (1.2%), breakage of the prosthetic stem (0.8%), fracture of the femoral diaphysis on a loosened cemented prosthesis (0.4%), breakage of the prosthetic neck (0.4%), dislocation of the prosthesis (0.4%). A stem equal to or longer than 22 cm had to be used in 13 cases (5.3%), while a short stem (12-13 cm) or a standard stem (17-18 cm) was sufficient in the remaining 233 cases. The results were worse for the extra-long stem group as compared to those for the short/standard group; that is, there was 1 case (7.7%) of septic loosening that resulted in explantation, as compared to 2.6% (6 cases) of explantation resulting from aseptic loosening (3 cases) or septic loosening (3 cases) of the short/standard group. As concerns radiographic assessment, extra-long stems show bone stability in 69.2% of cases, fibrous in 23.1%, and loosened in 7.7%, while 97.7% of short/standard stems show bone stability, 0.9% fibrous stability, 1.4% instability.
Arthroplasty, Replacement, Hip↗
Cemented versus cementless stem-to-bone fixation: a long-term survival comparison.
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Adult↗
Hip arthroplasty after femoral osteotomy.
Osteotomy of the proximal femur is performed to treat numerous hip pathologies in order to improve the load axis of the coxofemoral joint, thus improving coverage of the femoral head; despite this, arthrosis-related pathology may progress, and this nearly always results in hip arthroplasty. Many authors report that the time interval between osteotomy and arthroplasty is approximately 5 to 10 years. It is the purpose of this study to evaluate the complications and the clinical and radiographic results of hip arthroplasty performed after proximal femoral osteotomy, comparing them with a control group for hip arthroplasty without previous osteotomy.
Adolescent↗
Osteorticular amyloidosis in a patient under dialysis treated by total hip arthroplasty: case report and review of the literature.
The authors present the case of a patient affected by kidney failure, who had been undergoing dialysis for several years when areas of osteolysis and bone resorption in the proximal femur and pathologic fracture appeared. She was treated surgically by hybrid total hip arthroplasty. The patient also complained of pains in other joints. The bone tissue taken from the osteolytic area was examined histologically. The test showed the presence of an amyloid substance. Microradiography and X-ray diffractometry carried out on the same samples confirmed the lack of mineralisation due to the presence of aluminum ions, presumably derived from dialysis. The high concentration of this element was confirmed by resum assay with spectrophometry in atomic absorption. Considering the results of the aforementioned tests, the patient was put on dialysis using a polymethylmethacrylate filter.
Amyloidosis↗
Neurogenic arthropathy of the knee due to chronic alcoholism: two case reports.
The authors report two cases of neurogenic arthropathy of the knee in patients affected by chronic alcoholism. The aim of the authors is to discuss the etiopathogenic theory (neurotraumatic or/and neurovascular) as well as the mechanism by which alcohol damages joints.
Aged↗
[Mini-laparoscopic cholecystectomy: indications, technique and results].
The improvement of results and patients quality life is the aim of surgical technique. Mini-laparoscopic cholecystectomy brings not only to a better cosmetic results, but also to a decrease of post operative pain, analgesic use, hospital stay and an early return to normal activities. In this study, Authors report their own experience about mini-laparoscopic cholecystectomy using 5 mm and 3 mm trocar. Patients suffering from biliary sludge, microscopic lithiasis and mild or moderate gallbladder inflammation can undergo this procedure.
Cholecystectomy, Laparoscopic↗
Evaluation of a simplified test for the rapid detection of antibody to the human immunodeficiency virus (HIV-1).
We describe a new simplified solid phase immunoassay for the detection of anti-HIV antibodies. The results obtained analyzing a panel of sera from subjects showing a different pattern of reactivity on enzyme immunoassays and on Western blot demonstrated high sensitivity and specificity. The test does not require experienced laboratory staff nor the use of costly laboratory instruments.
Adult↗