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Biomedical subjects

J Cuadros

Publications and source records attributed to J Cuadros.

18 recordsLinked to original sources

Age as a risk factor for severe manifestations and fatal outcome of falciparum malaria in European patients: observations from TropNetEurop and SIMPID Surveillance Data.

Previous studies have indicated that age is a risk factor for severe falciparum malaria in nonimmune patients. The objectives of this study were to reevaluate previous findings with a larger sample and to find out how strongly clinical outcomes for elderly patients differ from those for younger patients. Results of adjusted analyses indicated that the risks of death due to falciparum malaria, of experiencing cerebral or severe disease in general, and of hospitalization increased significantly with each decade of life. The case-fatality rate was almost 6 times greater among elderly patients than among younger patients, and cerebral complications occurred 3 times more often among elderly patients. Antimalarial chemoprophylaxis was significantly associated with a lower case-fatality rate and a lower frequency of cerebral complications. Women were more susceptible to cerebral complications than were men. Our study provides evidence that falciparum malaria is more serious in older patients and demonstrates that clinical surveillance networks are capable of providing quality data for investigation of rare events or diseases.

Age Factors↗

Observations of the impacts of some landfill leachates with clays.

Compacted clay liners are common, major, components of landfill leachate (fluid) containment systems. This is sensible, but knowledge and understanding of the longterm performance and behaviour of day mineral/landfill leachate systems remain very limited. The authors studied the reactions of day soil with leachate simulants related to three different climates and waste cultures. The day came from a Tertiary sequence near Melbourne, Australia, a type in common use locally for landfill engineering. X-ray diffraction was used to observe mineralogical change in 3 mm clay plugs caused by reactions with the leachate simulants. Changes in hydraulic conductivity were also measured. The results show both that the different leachates have distinct effects on the clay minerals, and that the leachate/day reactions have direct measurable and distinct impacts on hydraulic conductivity. The laboratory studies were completed at the University of Melbourne. The X-ray diffraction work was completed at The Natural History Museum in London. The experimental results are discussed here and indications given of some potential implications.

Aluminum Silicates↗

Imported Falciparum malaria in Europe: sentinel surveillance data from the European network on surveillance of imported infectious diseases.

Malaria continues to have a high morbidity rate associated among European travelers. Thorough recording of epidemiological and clinical aspects of imported malaria has been helpful in the detection of new outbreaks and areas of developing drug resistance. Sentinel surveillance of data collected prospectively since 1999 has begun within TropNetEurop, a European network focusing on imported infectious diseases. TropNetEurop appears to cover approximately 10% of all patients with malaria seen in Europe. Reports of 1659 immigrants and European patients with Plasmodium falciparum malaria were analyzed for epidemiological information and data on clinical features. Regional data were quite diverse, reflecting local patterns of immigration and international travel. By far, the most infections were imported from West Africa. Europeans had more clinical complications; consequently, all deaths occurred in this group. Compared with European standards, the mortality rate was low (0.6% in Europeans). Data from TropNetEurop member sites can contribute to our understanding of the epidemiological and clinical findings regarding imported falciparum malaria.

Adolescent↗

The role of surgery in stage IV neuroblastoma.

BACKGROUND/PURPOSE: The importance of primary tumor resection in stage IV neuroblastoma is controversial. The authors analyzed prospectively the role of surgery in a multicentric series of stage IV neuroblastoma patients. METHODS: Patients were studied according to the International Neuroblastoma Staging System (INSS) recommendations. Age, sex, location of the tumor, type of metastases, time of resection (initial or delayed), extension of resection, surgical complications, pathology, N-myc and Shimada classification results, relapses, and outcome were studied. After diagnosis, children received induction chemotherapy followed by delayed surgery and autologous stem cell transplantation or maintenance chemotherapy. Resection was classified as complete (C), greater than 90% (P1), greater than 50% (P2), less than 50% (P3), and biopsy (B). RESULTS: Ninety-eight stage IV children were admitted in the study from June 1992 to July 1999. Seventy-six were older than one year, and in 78 the primary tumor was abdominal. Bone was the most common metastatic site followed by bone marrow. Initial biopsy was performed in 74 patients, and resection in 6, with one complication in each group. N-myc was amplified in 20 of 80 tumors, and Shimada was unfavorable in 45 of 67. Delayed surgery was performed in 70 cases, achieving gross total resection in 55 (79%); there were minor complications in 10%. Mean survival rate time was 50 months. Event-free survival rate (EFS) at 5 years for the entire series is 0.32, but 0.0 for children having biopsy only, 0.25 for less than 50% resection, 0.31 for 50% to 90% resection, 0.44 for greater than 90% resection, and 0.33 for complete resection. Differences were statistically significant only when compared with the biopsied group. EFS rate for infants was 0.56, but, again, there was no difference in relation to the type of resection. There were 46 relapses, 12 of them local, 7 of 20 N-myc-amplified tumors, and 4 of 60 not amplified (P <.005). CONCLUSIONS: Biopsies of stage IV neuroblastoma allow safe assessment of N-myc and other biological factors on tumor tissue. Delayed surgery after chemotherapy is performed with a low rate of complications, achieving a good local control of disease. N-myc-amplified tumors have higher local relapse rates than nonamplified and therefore would need more intensive local treatment. The final outcome in these patients is determined more by metastatic relapses than by the degree of resection.

Abdominal Neoplasms↗

Splenic littoral cell angioma in an infant.

A 1-year-old girl presented with fever, asthenia, and splenomegaly with hypersplenism. Abdominal ultrasound scan and magnetic resonance imaging showed multiple nodular cystic masses in an enlarged spleen. The histological examination of the resected spleen showed a novel type of vascular tumor called littoral cell angioma. The histopathologic and immunohistochemical features of this rare lesion are described. Distinction from other splenic vascular tumors is stressed because the clinical behavior of this new entity seems to be benign.

Diagnosis, Differential↗

Evaluation of the AxSYM monoclonal cyclosporin assay and comparison with radioimmunoassay.

Recently, a semiautomated fluorescence polarization immunoassay (FPIA) for determination of parent cyclosporin (CsA) has been developed for the Abbott AxSYM system. The new CsA assay measures the drug from an extracted whole blood specimen. The authors report here the evaluation of this new assay and the comparison with a previously validated radioimmunoassay (RIA) method (CYCLO-Trac SP). To assess the imprecision, the authors used tri-level controls supplied by both Abbott and Bio-Rad manufacturers. The within-run CV ranged from 4.4% to 7.3% and the between-day CV ranged from 4.4% to 7.6%. Mean recovery of the drug from clinical specimens spiked with kit calibrators was 108.4%. Fluorescence polarization immunoassay AxSYM (y) was correlated to RIA (x) by using 132 trough blood specimens (44 renal, 44 liver, and 44 heart) from transplant recipients and resulted in the following Passing-Bablok linear regression equation: y = 6.7 + 0.97x, r = 0.989, S(x/y) = 12.9. The percentage of overestimation (mean, range) by FPIA AxSYM versus RIA was (3.8%, range -17.7% to 39.1%). The results observed with this new method from follow-up studies in patients during the early course after transplant were not consistently higher than those obtained by RIA. These findings contrast with previously reported results that compared FPIA TDx assay with RIA. The authors conclude that FPIA AxSYM is a precise method for measuring CsA and offers results similar to those obtained by RIA with a marked reduction in assay time.

Cyclosporine↗

[Surgery of lung metastasis].

INTRODUCTION: The 30-40% of the oncologic patients have pulmonary metastases. Lung can be the only organ affected. In selected patients, exeresis of the pulmonary nodules can mean their healing. MATERIAL AND METHODS: Between 1982-1997, twenty two patients presented metastases, 13 could be operated and 16 thoracotomies were done. There were 53% boys and 47% girls whose ages ranged from 3 to 15 years. We have considered: pulmonary tumour location, disease free interval, number of metastases, surgical technique and incomplete pulmonary tumour resection. RESULTS: Primary tumours were: Wilms tumours 23%, bone tumours 67% (Ewing and osteosarcoma). Disease free interval was < 2 years in 8 patients (61%) and > 2 years in 39%. X-Ray and CT were performed in every case and 66% presented a solitary nodule. Surgical techniques were: metastasectomy in two cases (12%), wedge resection in 8 (50%) and lobectomy in six cases (38%). We made thoracoscopy in two patients. There weren't postoperatory mortality but the patients with tumorectomy had an incomplete surgical resection. The overall survival is 54 percent and the 5 years survival is 23 percent (3 patients). CONCLUSIONS: The patients with a DFI < 2 years have a survival of 25% compared with 100% for patients who have a DFI > 2 years. The pulmonary resection in selected patients can offer better survival. We can use the thoracoscopy in same selected patients.

Adolescent↗

Bronchial mucoepidermoid tumor in a 3-year-old child.

A 3-year-old girl was evaluated for persistent middle lobe atelectasis. Fiberoptic bronchoscopy revealed a spherical mass occupying the middle-lobe bronchus. The biopsy specimen disclosed a low-grade mucoepidermoid carcinoma. A lobectomy was performed. The patient is in good condition 2 years after the operation. Mucoepidermoid tumors are rare bronchial adenomas comprising 1% of all lung neoplasms. Children are very infrequently affected. The clinical behavior of these tumors is controversial. Surgical resection of the low-grade-type tumor has an excellent prognosis.

Bronchi↗

Primary neuroblastoma presenting as a paratesticular tumor.

A 3-month-old boy was operated on for an inguinal tumor. Histological diagnosis was neuroblastoma. This is the second known case of primary paratesticular neuroblastoma reported in the literature. The treatment of choice for Evan's stage I is surgery.

Diagnosis, Differential↗

Synovial sarcoma of the esophagus.

A 14-year-old girl presented with dysphagia and weight loss. Barium swallow, computed tomography, and endoscopy showed a polypoid intraluminal mass in the cervical esophagus. The tumor was locally resected and postoperative chemotherapy and radiotherapy were administered. Histological examination of the surgical specimen established a diagnosis of synovial sarcoma. The patient remains free of discernible disease 30 months after surgery. Esophageal sarcomas are rare tumors. This appears to be the second reported case of esophageal synovial sarcoma in a child.

Adolescent↗

[Intestinal anastomosis by biodegradable rings].

During an 9-month period (March to November 1992), six children underwent an intestinal anastomosis by means of a biofragmentable ring (BAR). Patients ages ranged from 5 to 16 years old. There were no mayor complications at surgery. The main technical problems was the difference of size between BAR and intestinal lumen. No patients in which BAR was used have presented fistulae, dehiscence or anastomotical stenosis.

Abdomen↗

[Locoregional anesthesia in surgery with day hospitalization. Our experience with 240 cases].

Locoregional anaesthesia has become an excellent complement of conventional general anaesthesia, because it results in efficient postoperative pain relief and is easy to carry out. We have performed two types of anaesthetic blockade: of peripheral nerve (dorsal nerve of the penis and abdominogenital nerve) and caudal block. Both have been employed in pediatric day surgery with good results in postoperative pain relief and with no complications. Advantages such as early recovery of oral feeding and the normal activity of the child are possible when using these techniques of locoregional anaesthesia.

Adolescent↗

[Calcified appendiceal calculi in children (author's transl)].

Authors present, a series of 73 infantile appendicular interventions, the high incidence of coproliths found in the appendix lumen (30.13%) which contrasts with the number presented by other authors which oscillate between 0.64 and 15%. The radiologic study of the extirpated appendix shows coproliths which has not been visualized in the preintervention-radiologic exploration. Due to this, authors consider convenient the study of the extirpated piece in order to the exact evaluation of the number of coproliths. Microscopic analysis and infrared spectrophotometry show the existence in the composition of the coproliths abundant in-organic material as well as organic acids and hydrocarbons.

Appendicitis↗

[Choledochal cyst (author's transl)].

This paper reports six pediatric patients with congenital choledochal cyst. From the long-term follow-up results of the six patients authors conclude that primary excision of the choledochal cyst and Roux hepatic jejunostomy are the first choice treatment for this lesion. However, it may not be possible in all cases, and choledochocystoenterostomy would then be useful as a second choice.

Biliary Tract Diseases↗

[Neonatal gastric perforation (author's transl)].

Three cases of neonatal gastric perforation of unknown etiology are presented. All three patients are female, one of them a second twin and two of them less than 2,000 g. in weight. All the patients were born under anoxic deliveries and needed resuscitative treatment. Digestive and respiratory symptoms started in all between the 2nd and the 4th days of life. Diagnosis, clinically suspected, is established radiologically. Perforations were surgically closed in all three patients. Two remain alive.

Female↗