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Biomedical subjects

E Otero

Publications and source records attributed to E Otero.

48 records · Page 3Linked to original sources

Acquired epileptic aphasia (the Landau-Kleffner syndrome) due to neurocysticercosis.

A healthy 7-year-old boy developed a language disorder associated with clinical seizures and a paroxysmal EEG. Computed tomography and magnetic resonance imaging revealed a small cysticercus deep in the left Sylvian fissure. We postulate a cause and effect relationship between the parasitic cyst and the clinical manifestations supported by the strategic location of the cyst and the critical age at which this lesion developed. This case provides evidence that the syndrome of acquired epileptic aphasia may be explained in terms of an unilateral structural brain lesion.

Aphasia↗

Serum immunoglobulins (IgG, IgA, IgM) in chronic hepatitis C. A comparison with non-cirrhotic alcoholic liver disease.

BACKGROUND/AIMS: Serum immunoglobulin concentrations are commonly elevated in patients with liver cirrhosis. Immunoglobulin class increase may vary depending on the cause of liver disease. Hepatitis C virus is, together with alcohol, a leading cause of chronic liver disease. The present study aimed to evaluate serum IgG, IgA and IgM levels in chronic hepatitis C. Results were compared with those of patients with non-cirrhotic alcoholic liver disease and healthy controls. Special attention was given to cases with minimal liver disease, as an approach to evaluate if the causing agent, independently of liver damage, influences serum immunoglobulin levels. METHODOLOGY: A total of 274 patients with histologically-proven chronic hepatitis C, 121 alcoholics with non-cirrhotic liver disease (steatosis or alcoholic hepatitis), and 75 healthy controls were studied. Serum IgG, IgA, and IgM were assayed by nephelometry. RESULTS: Serum IgG was increased in patients with chronic hepatitis C with respect to both alcoholics (p < 0.001) and healthy controls (p < 0.001). IgG levels were similar in alcoholics and in controls. IgA was increased in patients with non-cirrhotic alcoholic liver disease with respect to both chronic hepatitis C patients (p < 0.001) and controls (p < 0.001). IgA values were similar in subjects with chronic hepatitis C and controls. Selective IgG or IgA alteration was present in cases with minimal liver disease (chronic hepatitis C with a Knodell index equal or lower than 3, and alcoholics with liver steatosis, respectively). CONCLUSIONS: Hepatitis C virus and alcohol are linked to a selective increase of serum IgG and IgA, respectively, even in cases with mild or minimal liver disease.

Adolescent↗

[Effect of a 3-in-1 block in arthroscopic knee surgery. Comparative study with subarachnoid block].

HYPOTHESIS AND OBJECTIVES: Trunk blockades in arthroscopic knee surgery are rarely performed because combined blockade of the sciatic and lumbar plexus nerves are required, particularly if ischemia is required. We aimed to assess the efficacy of the "3-in-1 block" combined with intraarticular infiltration of local anesthetic for arthroscopic meniscectomy. The results were compared with our standard technique, subarachnoid anesthesia. PATIENTS AND METHODS: Forty ASA I-II patients undergoing arthroscopic meniscectomy without ischemia. The patients were randomly assigned to receive "3-in-1 block" with 40 mL of 1.5% mepivacaine (T group, n = 20), or the standard technique of subarachnoid puncture with 3 mL of 2% lidocaine (S group, n = 20). Twenty minutes after puncture patients in both groups received intraarticular injections of 20 ml of bupivacaine 0.25% with 1:200,000 adrenaline in the knee. Surgery began 10 minutes later. We assessed requirements for sedation during surgery, degree of satisfaction during surgery according to the surgeon and the patient, hemodynamic variables at predetermined times, postoperative pain (on a verbal scale and related to consumption of analgesics in the first 48 hours after surgery), and the appearance of side effects attributable to anesthetic technique. RESULTS: Demographic variables were comparable in the two groups and no surgical events were recorded. Eighteen patients in the T group and one in the S group required sedation during surgery (p < 0.05). Blood pressure was significantly lower in the S group than in the T group (p < 0.05). No patient in the T group required atropine and/or ephedrine during surgery, whereas 5 patients in the S group did (p < 0.05). Postoperative evolution was similar in the two groups. No postoperative complications attributable to the techniques were recorded. CONCLUSIONS: The "3-in-1 block" combined with joint infiltration of local anesthetics may be an effective alternative when subarachnoid anesthesia is contraindicated in patients undergoing arthroscopic meniscectomy.

Anesthesia, Local↗