Neuroophthalmological manifestations of diabetes mellitus.
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Biomedical subjects
Publications and source records attributed to G Pardo.
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PURPOSE: This study was undertaken to estimate the incidence of retinal changes and determine the prevalence of ocular toxicity associated with tamoxifen treatment in a breast cancer population. METHODS: The study was based on a population cross-sectional survey, including 290 patients taking tamoxifen from 6 months to 12 years; 274 patients were analysed. The main outcome measures were the incidence of retinal changes and visual impairment. RESULTS: The incidence of retinal changes was 0.9% (3 of 274 patients). All 3 patients were asymptomatic. The length of tamoxifen treatment ranged from 39 months to 120 months in the affected patients, with cumulative tamoxifen doses ranging from 23.7 g to 73 g. CONCLUSIONS: Retinopathy in patients receiving low doses of tamoxifen is rare and, in our study, did not result in changes in visual acuity. We found no retinopathy in patients receiving tamoxifen within the first 3 years of treatment or in patients receiving a total tamoxifen dosage of less than 23.7 g. Although retinopathy can occur in a tamoxifen-treated population, its low incidence and an associated good prognosis for vision does not merit special screening for this problem.
This paper examines the association of clinical and sociodemographic factors, including age and sex, with the diagnostic characteristics of first episodes of schizophrenia. The study included all patients with a first episode of schizophrenia who made contact with any of the public mental health services of the Autonomous Region of Cantabria in Northern Spain over a period of 2 years. Diagnostic characteristics were determined using the Spanish version of the Present State Examination (PSE-9), and the Scales for the Assessment of Positive and Negative Symptoms (SAPS and SANS, respectively). The study confirms that the onset of schizophrenia tends to occur earlier in men than in women. However, neither sex nor age of onset were found to be associated with the clinical and psychopathological characteristics of the patients as established by the PSE-CATEGO-ID system. Furthermore, no other factors were found to be associated with these diagnostic characteristics. Being female, having a family history of mental illness, and a poor premorbid adjustment were found to predict negative symptoms as defined by SANS/SAPS scales.
The syndrome characterized by papillomacular bundle damage, central or cecocentral scotoma, and reduction of color vision can be produced by toxic, nutritional, or hereditary causes. Patients who present with such a picture should be evaluated for toxic sources such as tobacco or alcohol use. Nutritional deficiencies must be considered and a good family history should be obtained to explore hereditary factors. DNA mutation analysis is available to detect genetic abnormalities. A trial of nutritional replacement may be advisable even in the face of normal laboratory values. Previous reports have shown dramatic visual improvement with intramuscular hydroxocobalamin and other oral vitamin B complexes, even when specific deficiencies are not found.
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Multivariate statistical methods were used to do morphological determination of the amount and the relation of the astrocytic foot processes (AF), astrocytic lamina (AL) and dense zones (DZ) on hypothalamic capillaries. We corroborated that 100% of the perivascular membrane is surrounded by glial astrocytic cytoplasm. Principal component analysis shows that the original variables are independent of one another. Cluster analysis confirms the individual situation obtained through the principal component analysis. Discriminant analysis shows that the discriminant capacity of the 3 variables is very significant. For the potential interrelations of astrocytic foot processes, astrocytic lamina and dense zones we have clearly differentiated four groups of hypothalamic capillaries.
The insertion of two different types of intrauterine devices (Multiload 250 and Silver T) has been monitored in 97 patients through systematic exploration by echography and hysteroscopy. Both techniques seem to be highly reliable in spite of the observation of 9% misplacements of the IUDs not detected by echography. In addition, hysteroscopy enables the diagnosis of frequent associated pathology (endometrial hyperplasia, endometriosis, polyps) difficult to diagnose by echography. The present study demonstrates the fact that the ultrasonography confirmation of IUD localization in the uterus was not always accurate.
Abdominal and vaginal sonographic monitoring were compared in 45 patients undergoing follicular development for the purposes of artificial insemination (N = 22) and in vitro fertilization (IVF; N = 23). Transvaginal sonography recorded a significantly (p less than 0.05) higher number of follicles from cycle day 10 on, compared to the abdominal (sector and linear) approach. Starting on day 8, the size of the dominant follicle was also significantly (p less than 0.05) higher when transvaginal endosonography was used. The number of follicles greater than 15 mm on the day of human chorionic gonadotropin (hCG) administration was correlated with the number of oocytes retrieved in patients undergoing IVF. There was a significant linear correlation when transvaginal (r = 0.86, p less than 0.001) and sector (r = 0.57, p less than 0.05) scans were used.
The real value of vaginal sonography in the early diagnosis of ectopic pregnancy was assessed in 12 cases where ectopic pregnancy was suspected by clinical evolution and levels of B-HCG, and subsequently confirmed by microlaparotomy. The results were compared with those obtained with abdominal sonography and values of B-HCG. Vaginal sonography gave no false negatives and the percentage of false positives was 16.6%. The most typical echographyc images were: 1. Adnexal Mass (50%), 2. Pseudoring (42%), 3. Yolk sac &/or Embryo &/or Heart rate (25%). Values of B-HCG greater than 600 mIU/IS without embryo from 35th day are highly suspicious with regard to ectopic pregnancy.
In the 28th week of gestation a normal foetus and a holoacardius were diagnosed via sonography in a biamnotic monochoriatic twin pregnancy. The growth of the foetuses was observed under continuous sonographic control up to the 40th week of pregnancy. The patient delivered a healthy twin by Caesarean section and the acardius was subjected to a postmortem. Macroscopic and histological findings in the foetus, the placenta and the umbilical cords are demonstrated. The pathogenesis of the holoacardius is discussed as being due to chromosomal aberrations and foeto-foetal transfusion syndrome.
Based on personal studies, Langerhans' cells are described. The origin of these cells, their morphology, their distribution and function in genital tract, and their relation with the origin of cervical cancer, are studied.
Granular cell myoblastoma (MGC) is an uncommon benign tumor of mesodermal origin of which no more than sixty cases with genital involvement have been reported. Among the genital organs, the labium majus of the vulva are the predilect site. We hereby contribute three new cases with a genital location (two in the vulva and one in the breast) and review the literature on the subject.
The ontogeny of thyrotropin-releasing hormone (TRH) in pancreata of human foetuses from 15-36 weeks of gestation and of infants has been studied. TRH was detectable in the pancreas of a 15 week old foetus; a progressive increase of pancreatic TRH content was observed until the 34th week of gestation, whereas a progressive decrease was found in the late period of pregnancy and in 1 year old infants. In contrast, the pancreatic insulin content showed a progressive increase during the entire pregnancy and in the first year after birth. These data indicate that TRH and insulin have different ontogenetic patterns in the human pancreas.
In order to evaluate whether and how far lyophilised human dura mater deserves to be preferred in repair surgery of large defects of the abdominal wall, the Authors present and discuss the results they obtained during the course of experimental research. In the light of personal histological documents, they stress the absence of reject phenomena and the peculiar capacity of the prosthesis for substitution by cicatricial tissue, properties which, together with the complete re-epithelialisation of the peritoneal mesothelium and the resistance to mechanical stresses, evidence that lyophilised dura mater must rightly be given preference in plastic reconstruction of large defects of the abdominal wall.
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In order to evaluate whether and how far a fuller case documentation can contribute to a better knowledge of the real possibilities of the lyophilised human dura mater in the field of vesical alloplastic surgery, the Authors present and discuss the results they obtained during the course of experimental research. In the light of personal histological documents, they stress the absence of reject phenomena, a property which, together with the absence of precipitates, the complete re-epithelialisation of the transition epithelium and the possibility of ensuring good vesical capacity, evidence that lyophilised human dura mater has full rights to a place in repair surgery of large vesical wall defects.
In order to evaluate whether and how for lyophilized human dura mater deserves to be used in the field of ureteral alloplastic surgery, the authors present and discuss the results they obtained during the course of experimental research. In the light of their personal histological documents, they stress the absence of reject phenomena, a property which, together with the absence of precipitates, the complete reepithelialisation of the transition epithelium and the ability to ensure normal ureteral perviousness, evidences that lyophilised human dura mater has full rights to a place in substitutive surgery of a segment of ureter, in particular the lumbo-liiac segment.
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