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Biomedical subjects

F Vilardell

Publications and source records attributed to F Vilardell.

120 records · Page 7Linked to original sources
PubMedDate not supplied

Endoscopic cytology of cancer of the esophagus and cardia: a long-term evaluation.

Between January 1979 and December 1986, 858 endoscopic cytological examinations of the esophagus were performed, including 309 patients with confirmed malignancies. A positive cytological diagnosis of cancer was made in 289 (93.5%). Adequate biopsies were obtained in 269 instances (87.0%), being positive in 238 cases (overall positivity of biopsy, 77.02%). The combined use of biopsy and cytology provided a correct diagnosis in 98.0% of cases. The cytological examinations were positive in 30 of 40 patients (75.0%) with obstructing lesions in whom no satisfactory biopsies could be obtained. No false positive diagnosis was made among the 550 patients with benign conditions. In this series, cytology increased the yield of biopsy by 20.8%.

Adenocarcinoma↗
PubMedDate not supplied

Value of second-look endoscopy after injection therapy for bleeding peptic ulcer: a prospective and randomized trial.

A prospective and randomized trial involving 104 patients was performed to assess whether second-look endoscopy could improve the efficacy of injection therapy for bleeding ulcers. The inclusion criteria were the presence of active arterial bleeding or a non-bleeding visible vessel at emergency endoscopy. All the patients received emergency injection of 1:10,000 adrenaline and were subsequently randomized (52 patients in each group) according to whether or not they would receive a second elective endoscopy within the first 24 hours with repeated injection if a visible vessel was still identified. Both groups were well matched for clinical and endoscopic data. A tendency towards better results was noted in the group that received a second-look endoscopy; the two groups were compared in regard to further bleeding (21% versus 29%, 95% confidence interval of the difference = -24.3 to 8.5), need for emergency surgery (8% versus 15%, 95% confidence interval of the difference = -19.9 to 4.5), transfusion requirements (1.7 +/- 1.9 versus 2.5 +/- 2.5 units, 95% confidence interval of the difference = -1.6 to 0.07), length of hospital stay (9.3 +/- 8.6 versus 11.8 +/- 10.8 days, 95% confidence interval of the difference = -6.2 to 1.4), and mortality rate (2% versus 4%). Although these trends did not achieve statistical significance, a type II error cannot be ruled out. However, according to our results, several hundred patients would be required to demonstrate statistically these relatively small differences.(ABSTRACT TRUNCATED AT 250 WORDS)

Emergencies↗
PubMedDate not supplied

[Ethical problems of medial technology].

Ethical problems are constantly arising in medical practice, especially in connection with the use of cutting-edge technology for diagnosis and treatment. The high cost of these resources means that they have to be used selectively, and at that point decisions are made about who should and should not get to use them. In recent years there have been increasing charges of improper use of these new technologies, coupled with increasing discussion of the costs and the benefits. Unfortunately, the use of such technology tends to spread indiscriminately and, as a result, to add to the cost of health care. Given this situation, it is essential to examine the relevance of the new diagnostic and treatment methods, the causes of technological abuse, the ethical aspects of the use of medical technology, and even the relationship between technology and society.

Ethics, Medical↗