Biomedical subjects
Publications and source records attributed to F Alvarez.
Seven new carbocyclic nucleosides derived from indan (1a-g) were efficiently prepared from 1,2-indanedimethanol vía Mitsunobu reaction with 6-chloroadenine and subsequent introduction of the appropriate substituent.
Anti-endoplasmic reticulum antibody positive autoimmune hepatitis in children is characterized by the recognition of a single 50,000 MW protein of the endoplasmic reticulum in liver microsomal fractions by their sera. We have developed an enzyme-linked immunosorbent assay technique with rat liver microsomal preparations as the antigen to be used for detection of this disease. Titers obtained may be useful in following the course of the disease and as an aid in determining when therapy can be discontinued. The technique is rapid, sensitive, reproducible, and simple to perform and is easier to manipulate than immunofluorescence or radioimmunoassay techniques.
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INTRODUCTION: Neurocysticercosis is the most frequent central nervous system parasitosis, although quite infrequent in our country. Its rising incidence can be explained by immigration from regions of the world where this disease is endemic. OBJECTIVE: This paper reviews treatment options for this condition. PATIENTS AND METHODS. Eight patients have been diagnosed with neurocysticercosis in the last three years in our hospital. Patient age, sex, origin, symptoms, CT and MR images, diagnostic tests, treatment and duration of medical treatment and clinical and neuroradiological evolution are examined. RESULTS: Patient age ranged from 25 to 33 years, all eight came from South America and the most frequent initial symptom was an epileptic crisis. Two patients had a single lesion, six had multiple lesions and all eight showed the lesion in the parenchyma. Only 50% showed a positive serum ELISA test for Taenia solium. Initial treatment was surgical in only one patient and the other seven received albendazol. In one of the latter the drug was ineffective and surgery was undertaken. A ten month follow up period has found a favorable evolution in all the patients, who are all also asymptomatic at the present time. DISCUSSION AND CONCLUSIONS: Neurocysticercosis is more common among immigrants than the local population in Spain. The initial treatment should be medical, with surgery as an option for non responders. We believe that duration of the medical treatment will depend on the patient and the clinico radiological evolution of his/her disease.
AIMS: The aim of this study is to survey the literature and update the steps to be taken in managing a pregnant patient in whom cerebrospinal fluid (CSF) shunting has been performed. DEVELOPMENT: The risk of valve malfunction (VMF) during pregnancy is approximately 27.5% and is mainly produced by a functional obstruction due to an increase in intra abdominal pressure during gestation. The risk of VMF and complications rises until 6 months after childbirth. The study of the functioning of the shunt and genetic counselling prior to conception are of vital importance. We discuss the steps to be taken during pregnancy, and during and after childbirth, as well as the implications of CSF shunting in a pregnant patient from a neurological, neurosurgical, obstetric and anaesthetic point of view. Although maternal progress is excellent (100% were asymptomatic 6 months after childbirth), there is also a very high percentage of miscarriages (24%) of unknown causation. CONCLUSIONS: Prospective studies are needed to explain different conflicting points in the series currently available.
INTRODUCTION: Ischemic symptomatology related to the presence of saccular brain aneurysms is infrequent, and this makes it difficult to reach a widespread agreement about the most suitable treatment. CASE REPORT: A 17-year-old male with symptoms of little stroke produced by distal embolisation of an aneurysm in the middle cerebral artery. The patient was treated by endovascular aneurysm exclusion. CONCLUSIONS: In patients with no other identifiable cause of ischemic attacks, the possible presence of a brain aneurysm must be taken into account. First choice treatment is the obliteration of the aneurysm using endovascular techniques. If the approach to the aneurysm (either endovascular or surgical) entails a high risk for the patient, another possibility is to use antiplatelet drugs.
We present 11 patients with intracranial gangliogliomas. The age ranged between 4 and 69 years with a mean of 32 years. The most frequent clinical manifestations were epilepsy in 7 cases and headache in 4 cases, and had begun from 15 days to 12 years before diagnosis. The gangliogliomas were located supratentorially predominantly in the temporal lobe (5 cases), except one, which was located within the cerebellum, which is extremely rare. EEG evidenced focality in 8 cases. The CT scan showed hypo or isodense images which were often associated with cysts, and that partially or totally enhanced with contrast administration in 7 cases (63.3%). Calcification was seen in only one case (9%). All our cases were treated surgically. Three patients were reoperated for recurrence. One case was reoperated twice and the histologic study showed astrocytoma grade II. Radiotherapy was given in two cases. In one case after subtotal surgery and in the other after the second operation for recurrence. Follow-up ranged between one and thirteen years, with a mean of 6.8 years. There was only one death. We used the CT scan for follow-up. However, nowadays MRI is more useful than the CT scan to distinguish recurrences.
In 1986-87, a qualitative research project was conducted in the Dominican Republic, Egypt, Indonesia, and Thailand to expand understanding of the acceptability of NORPLANT contraceptive implants beyond inferences made on the basis of continuation rates. In each of the four study sites, focus group discussions or in-depth interviews were held with potential acceptors, current NORPLANT users, discontinuers, husbands of women in these three groups, and service providers. Nonclinical participants generally had little formal education and lived primarily in urban or semi-urban areas where NORPLANT has been available for at least five years. The study focused on attitudes, perceptions, and experiences of each group regarding NORPLANT implants. Results suggest that factors having an impact on the acceptability of NORPLANT implants fall into three general categories: medical/technical, cultural/religious, and informational/educational. This article discusses each of these categories, including programmatic implications of the findings, and puts forward recommendations for enhancing NORPLANT introduction efforts on the basis of these findings.
Our initial experience with surgical treatment of congenital heart disease in 141 consecutive cases without the need of hemodynamic study is described. Ages ranged between 1 day and 15 years; 39 cases under 1 months of age (23 in the first week of life), 38 between 1 and 12 months, and 64 above 1 year of age. Diagnosis were: ductus 32 cases, atrial septal defect 24, Fallot's tetralogy 14, aortic coarctation 13, complete AV canal defect 7, D-transposition of the great arteries 5, ventricular septal defect 6, pulmonary atresia with intact ventricular septum 5, aortic stenosis 3, tricuspid atresia 4, pseudotruncus 2, univentricular heart 2, atrial myxomas, 2, Fallot's like 3, other type of congenital heart defect 19 cases. There was an adequate correlation between eco-2D images and anatomic-surgical findings. In conclusion, we think that a great percentage of cases affected of congenital heart disease should be considered for surgery without the need of a hemodynamic and angiocardiographic study.
A 68-year-old woman with a subarachnoid hemorrhage was operated on for an anterior communicating artery aneurysm demonstrated by angiography. A month later she developed intestinal hemorrhage and a selective angiography showed multiple aneurysmatic dilatations, which were compatible with angiodysplasia, to be the cause of the intestinal bleeding. This association of intracranial and extracranial aneurysms is infrequent.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
One case of traumatic posterior fossa subdural hematoma (PFSH) is described. This location represent 1% of the subdural hematomas. Computerized Tomography (CT) was used in the diagnosis and follow-up of the hematoma. The etiology and physiopathology of this process are discussed.