[Conservative treatment in splenic injuries. Results of a follow-up in patients with autotransplants].
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to G Carrillo.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Two cases of chordoma of the sacrococcygeal region have been histochemically evaluated. In both cases an irregularly shaped stellate cell, containing large amounts of glycogen, is the prevailing cell type. Neoplastic cells interact with an extracellular matrix consisting of a collagenous framework and a heterogeneous family of glycosaminoglycans with a prevalence of chondroitin sulfate chains and, to a smaller extent, of hyaluronate molecules. We emphasize the value of these data in order to differentiate this tumor from other sacrococcygeal neoplastic lesions.
Forty-seven lymph nodes and one stomach exhibiting reactive hyperplasia from 40 patients were examined by morphologic and immunologic methods. Twelve lymph nodes and one stomach from ten patients had a significantly increased number (greater than 25%) of lymphocytes, with single class surface immunoglobulins or plasma cells, and plasmacytoid lymphocytes secreting single class immunoglobulins. In three cases, a diagnosis of malignancy was subsequently made on the basis of morphological and immunological evidence of tumor in other tissue. Five patients had collagen disorders, two had a persistent unexplained hypergammaglobulinemia, and two had no recognized associated disease. The significance of an increase of B lymphocytes with single class surface immunoglobulins in these cases is presently not clear, but patients with similar findings should have extensive investigation and persistent follow-up.
T lymphocytes, forming sheep erythrocyte rosettes at 37 degrees C, have been described in thymus glands, mitogen and allogeneic cell stimulated lymphocyte cultures, and acute T cell lymphoblastic leukaemia. This paper describes the finding of such lymphocytes in lymph nodes of a variety of disorders including Hodgkin's disease, Lennert's lymphoma, malignant lymphoma of large transformed T lymphocytes, immunoblastic lymphadenopathy, metastatic carcinoma, and other disorders. A large number of tonsils, but not reactive lymph nodes, also contained a significant number of those T lymphocytes. The significance of these findings in relation to interpretation of immune red cell rosettes and to the subclasses of T lymphocytes is discussed.
In the first part of the article the assertion is made that educational corpus of technology should not be regarded as something apart, but as a corpus of teaching methods, techniques and resources rationally organized to solve problems of material and conceptual situations and processes. Several educational technologies are explained on the basis of their underlying theoretical frameworks, and grass-root educational technology is advocated because, while it does not emphasize efficiency, it is capable of inducing innovations that are effective in that they actually accomplish changes. The second part reviews the results of the Latin American Program for Educational Technology in Nursing, which PAHO conducts through a network of centers in the nursing schools of several countries. The purpose of the Program is to disseminate modern educational technology and to endeavor to harmonize nurse training with demands and trends in the delivery of health services.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
This paper reports the results of a survey of child-feeding practices and related social phenomena in Costa Rica, a country representative of many maturing, less developed nations. The data were collected for use in developing a remedial nutrition programme and to provide a basis for a later evaluation of that programme.The results show that child-feeding practices are in need of improvement, particularly among mothers with relatively little formal education and especially during the first year of life and during periods of sickness. More mothers, regardless of their educational level, should be encouraged to breast-feed and to do so for longer periods. The data also showed a need to improve the general health environment in large families as a means of reducing infant mortality, especially when the mother is relatively uneducated. Radio is a particularly promising channel of health communication, especially for the relatively uneducated. Ways in which mass communications media could be used for health education should be explored.
Explore the source record for details and available documents.
The objective of this study was to evaluate the risk factors associated with mortality in interstitial lung disease patients. We performed a retrospective study of 722 consecutive patients submitted for lung biopsy during the 1986-1990 period. Twenty-two (3%) died within the 30 days following surgery. Forty-four patients who survived after the surgery for the same time span were randomly chosen as control group. Dyspnea at rest was present in 18/44 of surviving group (SG) and in 18/22 of the nonsurviving group (NSG) (OR 6.5, 95% CI 1.8-22.4,p = .001). Systemic diseases (i.e., diabetes, systemic arterial hypertension)were mainly present in the NSG (OR 7.2, 95% CI 2.3-22.8, p < .001). The SG displayed significantly less respiratory insufficiency with a PaO2 of 52.2 + 8.4 versus 38.5 i 9.4 mm Hg, and PaCO2 of 28.8 i 4.5 versus 38.5 +/- 9.2 mm Hg, respectively (p < .001). Likewise, the SG exhibited a PaCO2/PaO2 ratio of 0.5 - 0.1, while in the NSG it was of 1 +/- 0.4 (p < .001), showing a sensitivity of 84% and specificity of 93% for mortality. Multiple logistic regression analysis for these variables showed that log likelihood was still significant for PaCO2 > 34 mm Hg, PaO2 <48 mm Hg, and comorbid diseases. Logistic regression analysis of these three variables showed the greatest sensitivity and specificity (84 and 750/0,respectively) for prediction of mortality. However, the strongest association was found when PaCO2/PaO2 ratio was analyzed alone (OR 21,073,CI 95% 28-15,946,357, p < .005). These data suggest that PaCO2/PaO2 ratio appears to be a predictor of mortality in this subset of patients. Its prospective use has reduced early mortality after surgery less than 1% in the last decade.
INTRODUCTION: Evidence of a high prevalence of hiatal hernia (HH) and gastroesophageal reflux (GER) in asthmatic patients has been found. However, the relationship between these entities has not been studied in our country. OBJECTIVES: 1) To inform the prevalence of hiatal hernia in asthmatic patients, 2) To compare the prevalence of hiatal hernia in asthmatic vs. non-asthmatic patients, 3) To establish a possible association between hiatal hernia and GER in asthmatic patients. MATERIALS AND METHODS: In order to detect and to compare the prevalence of hiatal hernia in asthmatic and non-asthmatic patients, upper gastrointestinal endoscopy was performed. To establish the association between asthma and GER, data obtained from a gastrointestinal symptoms questionnaire, an esophageal manometry and an ambulatory pH recording in asthmatics with or without hiatal hernia were compared. RESULTS: Hiatal hernia was more frequently observed in asthmatics than in non-asthmatics (62% vs. 34%, p = 0.02). The frequency of typical symptoms of GER was similar in both asthmatics with or without hiatal hernia (54 vs. 43%, p = 0.3). Lower esophageal sphincter incompetence was similar in asthmatics with hiatal hernia (35%) vs. asthmatics without hiatal hernia (22%), as detected by manometry. Pathological GER was diagnosed by pH recording in 81% of the asthmatics with hiatal hernia and in 65% of asthmatics without hiatal hernia (p = 0.1). CONCLUSIONS: There is a high prevalence of hiatal hernia in asthmatics, which in turn results to be greater than in non-asthmatic patients. The presence of hiatal hernia does not correlate with the detection of pathological GER as determined by pH recording in this group of patients.
Between december of 1994 and june 1997, 90 children and adolescents were referred to the Shaio Clinic Foundation for evaluation of recurrent unexplained syncope. Head-up tilt testing was positive in 45 (50%), 23 male, with a mean age of 12.7 years (range 5-17 years). The response during Head-up tilt testing was predominantly vasodepressor (57%), followed by mixed in 24% and cardioinhibitory in the remaining 17%. The majority of patients had a positive response during pharmacological phase with isoproterenol infusion at a mean time of 17 +/- 8 minutes. Head-up tilt is a safe diagnostic test and defines the cause of unexplained syncope in up to 50% of children and young adults with recurrent syncope. The management was based on education, control of risk factors and psychological and/or physical rehabilitation. In the 15.2 months follow up we observed complete remission or a significant reduction of symptoms in 95% of the cases. Only 5% of the patients persisted or had worsening of their symptoms.
The prevalence of gastroesophageal reflux (GER) in asthmatic patients is elevated, but the exact frequency remains unknown. The relationship between GER and asthma has not been investigated in Mexico. The objective of this study is to know the frequency of GER in Mexican asthmatic patients and the possible relationship with the severity of asthma. Fifty patients with adult-onset asthma were studied. AII of them fulfill the diagnostic criteria of the National Institutes of Health, U.S. The evaluation included a symptoms questionnaire, spirometry, esophageal manometry, 24-h esophageal pH-recording, and an upper gastrointestinal endoscopy. Twenty-three patients had mild asthma (46%), 16 moderate (32%) and 11 had severe asthma (22%). Twenty-seven (54%) reported heartburn and regurgitation at least twice a week. The esophageal pH-recording showed pathologic GER in 37 subjects (74%) and endoscopic esophagitis was found in 7 cases (14%). The pH-recording showed pathologic GER in 13 patients with mild asthma (57%), in 13 with moderate asthma (81%) and in all patients with severe asthma (100%). The frequency of GER in Mexican asthmatic patients is high and increases proportionately with the severity of asthma. This factor must be considered in the integral evaluation of these patients.
The authors describe 9 cases of classic osteosarcoma treated with preoperative chemotherapy according to the current schemes and consecutively treated by surgery. All the patients were between 12 and 17 years old. They initially had a needle biopsy or open biopsy to confirm the diagnosis. After 2 cycles of chemotherapy they were treated by limb salvage procedure in 7 cases and by ablative surgery in 2 cases. The surgical specimens were very accurately examined both macroscopically and histologically to evaluate the effects of preoperative chemotherapy. For this reasons the quantity of the tumoral necrosis, that represents the reaction of the tumor to the therapy, was researched and mapped. The intention was to decide whether or not to use the same pharmacological treatment after the surgical therapy. These evaluation criteria do not only have the objective of locally keeping under control the disease, but mostly to oppose micrometastasis. In fact they are almost always present at the beginning of the symptomatology but are not diagnosed with the usual exams. The sites of viable tumor after treatment are: soft tissues around the bone, areas in contact with cartilage and subcortical areas. In 6 cases out of 9 we found macroscopically a fibrous pseudo-capsule around all the tumoral area. The follow-up of the nine cases varies from six to fifty-two months and presents the 66% of disease-free survival.
Explore the source record for details and available documents.
Recently, several different models of valvular prostheses have been developed in which biological material, like duramater and perycardium, is being used for their manufacturing. Since these valves have to be manufactured one by one, the possibility of obtaining heterogeneous results is very high, thus it is very important to have a system to evaluate the behavior of these prostheses. The objective of this project was to design and evaluate a cardiac cycle duplicator to test the function of valvular prostheses. The system consists of a double plexiglass chamber, separated by the valvular prosthesis being studied. The superior "auricular" chamber is connected to a reservoir where the height of the column of saline can be modified. The interior "ventricular" chamber is connected to a pump that generates pressure pulses at constant intervals which simulate ventricular systoles. The other end of the pump connects with an artificial Starling's resistance. The data obtained from this system allows the quantification of the following: 1) Functional diameter, form and area of maximal opening; 2) valve motility; 3) sufficiency of the prostheses; 4) velocity of valve opening and closing; 5) rigidity of the valves; 6) optimal pressure gradient for adequate valvular function. The system makes possible the evaluation and comparison of the function of these valvular prostheses.
Our objective was to assess the capacity of clinical and laboratory information to predict findings in the lung biopsy in interstitial lung diseases (ILD). We studied 121 patients with ILD as a cohort recruited in our institute from 1983 to 1987 with the diagnosis of hypersensitivity pneumonitis (HP) and usual interstitial pneumonia (UIP). Histologic diagnosis (HP vs UIP) and degree of fibrosis (< 50% of the biopsy surface vs > or = 50%) were used as the gold standard to compare a series of clinical and laboratory variables in the initial assessment. We used a stepwise logistic regression model to predict the biopsy results. The model was calculated in half of the patients selected by random sampling, and the calculated model was tested in the other half of the patients. Variables found to predict degree of fibrosis were (with relative risk RR and 95% confidence interval): a radiographic pattern of honeycombing (RR 5.0 from 0.9-29), digital clubbing (RR 8 from 1.4-48) and gender (RR 2.9 from 0.4-20). This model classified correctly 72% of the biopsies, with a sensitivity of 0.38, a specificity of 0.85 and a kappa of 0.25 +/- 0.19 (p = 0.17 NS). For histologic diagnosis (NIU vs NH), the model included gender (RR 6.6, 1.3-33), honeycombing (RR 1.6, from 0.4-6.0), digital clubbing (RR 4.6, from 1.2-18), and vital capacity expressed as percent of predicted (RR 0.96, from 0.92-1.00).(ABSTRACT TRUNCATED AT 250 WORDS)