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J Barba

Publications and source records attributed to J Barba.

At least 37 records · Page 2Linked to original sources
PubMed1992

Echocardiographic follow-up of right atrial tumoral invasion by hepatocarcinoma: a case report.

Hepatocellular carcinoma is known for its tendency to grow in the venous system. We describe a patient suffering from hepatocellular carcinoma with right atrial metastatic tumor. Echocardiography demonstrated a right atrial mass as a result of invasion of the inferior vena cava and next extension into right atrium. The autopsy showed an irregular polypoid mass that occupied the entire right and left atrium, hepatocarcinoma was confirmed by histologic studies. We advocate performing echocardiographic examination in patients with hepatocarcinoma who have cardiac symptoms and signs.

Adult↗
PubMed1992

Dynamic cardiomyoplasty in a patient with end-stage cardiomyopathy.

Dynamic cardiomyoplasty is a relatively new surgical procedure by which a transformed fatigue-resistant skeletal muscle wrapped around the heart is stimulated to contract in synchrony with it, thereby augmenting the ventricular functions of a failing heart. We performed a cardiomyoplasty with latissimus dorsii (LD) in a patient who was refused the heart transplant programme because of pulmonary hypertension and psychosocial contraindications. The patient was 34 years old, functional class grade IV of the New York Heart Association (NYHA), with a three-month history, due to ischemic cardiomyopathy with multiple vessels affected, 10% ejection fraction, arteriolar pulmonary resistance of 7.5 U Wood. Cardiomyoplasty was performed after training the LD muscle for four weeks. One week later the pacemaker was programmed in a DDD mode: amplitude 3.75 V, pulse duration 0.50 ms, AV delay 175 ms. The patient reached functional class grade I-II (NYHA). Inotrope support was discontinued and great clinical improvement was noted. The ejection fraction rose from 10% to 30%. Echocardiographic left ventricular outflow tract velocity increased from 0.33 m/s to 0.60 m/s. These values were compared with radionuclide angiocardiography and echocardiography evaluations. The great clinical improvement and positive changes in left ventricular parameters suggest that cardiomyoplasty is useful in the treatment of some cases of dilated or ischemic cardiomyopathy as an alternative to heart transplantation. Long term follow-up is necessary to evaluate this procedure.

Adult↗
PubMed1992

[Changes in diastolic function in heart rejection: role of Doppler echocardiography].

In acute cardiac rejection, left ventricular diastolic function is altered. To study these abnormalities and their utility in cardiac allograft rejection, we studied 56 cardiac transplant recipients. All patients were assessed with endomyocardial biopsy and Doppler echocardiography done in the same day. A total of 163 Doppler studies were recollected. Cardiac transplant recipients were excluded during the early 6 weeks postoperative period. Totally, 100 biopsies were normal, 48 positive for mild rejection (Billingham Gde I-II) and 15 positive for moderate or severe rejection (Billingham Gde III-IV). Compared to negative biopsies, during acute rejection left ventricular wald thickness significantly increased (p < 0.05); isovolumic relaxation period and pressure half-time significantly decreased (p < 0.05, p < 0.001 respectively). Nevertheless, increase in peak early mitral flow velocity was only significantly associated with severe rejection (p < 0.001). Correlating only progressive shortening of isovolumic relaxation period parameter in the diagnosis of graft rejection, we forward a high sensibility (85%) and low specificity (57%). Thus, Doppler echocardiographic evaluation of left ventricular diastolic function provides a non-invasive tool for early detection of acute rejection monitoring after the early postoperative period.

Adult↗
PubMed1992

Use of computerized interactive morphometry in the diagnosis of mammary adenoma and adenocarcinoma in dogs.

We attempted to define quantitative objective criteria for diagnosis of mammary adenoma and adenocarcinoma in dogs. To that end, correlation between diagnosis made by conventional histologic examination and morphometric descriptors, obtained by computerized histologic analysis, was assessed in biopsy specimens of mammary tissue from 63 dogs. We used 2 interactive computer procedures: one assessed mean nuclear perimeter, mean nuclear area, and circularity factor; and the other evaluated nuclear stratification and cell crowding. A data base was generated with 11 specimens from normal mammary tissue, 17 specimens from mammary adenoma, 18 specimens from low-grade mammary adenocarcinoma, and 15 specimens from mammary adenocarcinoma. The mean values of nuclear perimeter, nuclear area, nuclei per millimeter of basement membrane, and minimal distances from cells to basement membrane gradually increased from normal to high-grade malignancy. Distributions of nuclear areas and of minimal distances from cells to basement membrane were shifted in specimens from malignant tumors. Multivariate analysis confirmed the homogeneity of the diagnostic groups.

Adenocarcinoma↗
PubMed1990

[Clinical and angiographic study of intra-myocardial coronary bridges].

AIMS: Approach to the clinical profile of patients with intramyocardial coronary bridges. CONCEPT OF STUDY: Two years retrospective study on coronariangiography with a selection of patients, of our department, with myocardial bridges and no atherosclerotic lesions. MATERIAL AND METHODS: Out of 1620 patients, 26 cases had a suspected ischemic cardiopathy defined on the grounds of clinical, electrocardiographic, ergometric and coronariangiographic criteria. RESULTS: From the 1620 cases, 26 (1.6%) presented intramyocardial coronary pathes. All situated on the left anterior descendant artery. 10 of these cases showed left ventricular hypertrophy, a change which is frequently associated with myocardial bridges. There was no correlation between the severity of systolic coronary constriction and clinical data. CONCLUSIONS: The incidence of myocardial bridges in our group is different from other studies. The localization at the level of the left anterior descendant artery was the most frequent one. The findings in this study demonstrate a possible association between the intramyocardial coronary pathes and the left ventricular hypertrophy.

Adult↗
PubMed1990

[Death in exercise test: immediate angiographic findings in 2 cases].

We present two cases of mortality during a stress test after which coronary arteriography was performed after the acute event. In both patients, left coronary arteries presented eccentric lesions with irregular bordes and intraluminal lucencies. We have discussed the probable pathophysiologic mechanisms involved in view of the angiographic findings. We concluded that the cracking of the plaque was an essential event in the pathogenesis of this picture.

Coronary Angiography↗
PubMed1990

[Functional capacity and rhythm changes after atrial correction of transposition of great arteries].

A group of 12 patients, previously submitted to atrial correction of the transposition of the great vessels, were studied through stress test with direct metabolimetry and Holter to assess aerobic functional capacity and its relationship with conduction disturbances. The results were compared with those obtained with a control group of 23 non athletic healthy children. All the patients showed amputation of their heart rates on effort, though this parameter and the oxygen consumption were normal at low work load levels. The VO2 at anaerobic threshold, the maximum VO2, and the maximum work load were also decreased in most of the patients. Holter studies demonstrated sick sinus syndrome in nine of them. Aerobic functional capacity was reduced in most of the patients with atrial correction of the transposition of the great vessels. The amputation of the heart rate on effort is a common finding though its relationship with the decrease of the aerobic functional capacity in these patients is limited. Finally, the stress test is probably more sensible than Holter for the detection of slight degrees of sinus disfunction.

Adolescent↗
PubMed1990

Utility and tolerance of stress testing in geriatric patients.

OBJECTIVES: To determine the sensitivity and specificity of stress testing in geriatric patients and to estimate the tolerance of these patients to exercise. DESIGN: A prospective study done in two populations with different ages. SETTING: Cardiologists and a stress testing laboratory. PATIENTS: Persons with ages above and under 65 years who were admitted in our center and submitted to stress testing and coronary angiography for suspicion of ischemic heart disease. PROCEDURES: All stress tests were performed on a Siemens Elama cicloergometer model 380-B adapted to a Hewlett Packard 1517 A ECG recorder. Our protocol started with an initial work load of 30 Watts with increments of other 30 Watts every three minutes. A 12 lead ECG was registered at rest, at maximum effort and in the recovery phase (approx. eight minutes after maximum effort). Three leads ECG's (V2, aVF, V5) were registered every three minutes. Stress finishing criteria were: symptom's limited, fatigue and maximum heart rate (220-age). Blood pressure was also controlled every three minutes during exercise and every two minutes during the recovery phase. Coronary angiographies were performed on a Siemens Cardoskop U (cine) using the Judkins technique. Left anterior oblique, right anterior oblique and postero anterior projections were used in all the procedures. RESULTS: Stress testing presents high sensitivity and low specificity in geriatric patients. A good tolerance to exercise was observed in this group of patients. CONCLUSIONS: A similar sensitivity was observed in the stress tests performed by patients with ages above and under 65 years. Sensitivity seems to be related to the severity of the coronary lesion. On the other hand stress testing presented a lower specificity in the geriatric patient. Finally, good tolerance to exercise was observed in patients older than 65 years.

Aged↗
PubMed1989

[Coronary ectasis: another form of atherosclerosis].

In a review of 3,693 coronary angiographies carried out in our department for suspected coronary artery disease we evaluated the 69 patients (1.86%) in whom lesions of coronary ectasia were found. Most of them (n = 51) had associated stenotic lesions and only 18 patients had isolated ectasia. The most common localization of the 96 ectasia lesions found in these patients was the right coronary artery, followed by the left anterior descending and, finally, the circumflex coronary artery. The ectasia lesions were classified according to the morphological classification proposed by Ducceschi in the following types: I) fusiform; II) saccular; III) spherical; IV) linear or diffuse, and V) mixed. Most lesions in our series were diffuse. Regarding clinical features, significant differences were found in the higher incidence of atypical angina presentation in those patients with isolated ectasia lesions.

Aged↗
PubMed1989

[Sensitivity and specificity of the exertion test in elderly patients].

One hundred and fifty four patients who presented at our Institution for suspected coronary artery disease were evaluated. They were divided in two groups: A) 77 patients older than 65 years (X = 68.35 +/- 2.99 years), and B) 77 patients younger than 65 years (X = 51.01 +/- 7.50 years). Diagnostic exercise test and coronary angiography were performed in all. Most tests in both groups were terminated due to physical exhaustion (71% and 74% in groups A and B, respectively). During the exercise test there was a higher incidence of ventricular premature beats and lower limb pain in the older group, while angina was more common in the younger group. The overall sensitivity of the test was similar in both groups (88%), with a high prevalence in both (86% in group A and 78% in group B). The sensitivity regarding the extension of coronary artery disease was higher for the detection of one-vessel disease in the younger group (76% vs 63%), while it was higher in the older group for the detection of two and three-vessel disease (86% and 91% vs 84% and 80% in the younger group).

Aged↗
PubMed1989

The use of local entropy measures in edge detection for cytological image analysis.

Accurate edge detection is a fundamental problem in the areas of image processing and pattern recognition/classification. The lack of effective edge detection methods has slowed the application of image processing to many areas, in particular diagnostic cytology, and is a major factor in the lack of acceptance of image processing in service orientated pathology. In this paper, we present a two-step procedure which detects edges. Since most images are corrupted by noise and often contain artefacts, the first step is to clean up the image. Our approach is to use a median filter to reduce noise and background artefacts. The second operation is to locate image pixels which are 'information rich' by using local statistics. This step locates the regions of the image most likely to contain edges. The application of a threshold can then pin-point those pixels forming the edge of structures of interest. The procedure has been tested on routine cytologic specimens.

Algorithms↗
PubMed1985

Combination chemotherapy with high-dose methotrexate, bleomycin, and cisplatin in management of head and neck squamous cell carcinoma.

Fifty-nine patients with stage IV head and neck squamous cell cancer were treated with an intensive induction chemotherapy consisting of high-dose methotrexate-leucovorin, bleomycin, and cisplatin. Forty-five patients had recurrent disease following surgery and/or radiation therapy. The response rate in this group was 22%, with a median response duration of 10 weeks and a median survival of 19 weeks. The median survival in responders was 20 weeks and in nonresponders 18 weeks. Fourteen previously untreated patients (13 T4 and one T2) received identical chemotherapy followed by radiation and/or surgery. The response to chemotherapy in previously untreated patients was impressively higher (93%). These patients had a median survival of 48 weeks, and 30% survived 2 years. The initial chemotherapy did not compromise the succeeding radiation therapy or surgery. Toxicities were frequent, but generally well tolerated. It is concluded that prior surgery and/or radiation therapy compromises the efficacy of subsequent chemotherapy in head and neck cancer. Responses to intensive chemotherapy prior to surgery and/or radiation therapy are excellent in patients with T4 tumors and provides a basis for further intensive treatment in attempts to augment cure rates.

Adult↗
PubMed1985

Methylergonovine-induced spasm of saphenous vein coronary bypass graft.

A case of repeated methylergonovine-induced spasm of a saphenous vein bypass graft in a 56-year-old man is presented. Prior to the operation, spasm was induced by methylergonovine in the stenosed right coronary artery. Six months after the operation, coronary angiographic studies showed induced spasm of the right coronary graft but no spasm in native vessels nor in the other graft to the left anterior descending coronary artery.

Angina Pectoris↗