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Biomedical subjects

J Esparza

Publications and source records attributed to J Esparza.

123 records · Page 7Linked to original sources
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[Primary pyomyositis of the psoas muscles in a temperate climate. Review of two cases in children followed up over the long term].

BACKGROUND: We review two cases of primary pyomyositis of the psoas in children that occurred in Navarre, their management and long-term evolution. Primary pyomyositis of the psoas muscle is a rare infection in a temperate climate. Its diagnosis is difficult due to the similarity of the symptoms with several infectious processes, mainly septic arthritis of the hip in children and adolescents. The rarity of the present cases is due to several facts: occurrence in children, in a temperate climate (Navarre), immunocompetent patients and without subjacent pathology, besides their monofocal situation that is contrary to the more frequent multifocal presentation. These factors, besides the poor specificity of the symptoms, constitute a diagnostic challenge. METHODS: We present two patients (10 and 12 years old) with fever and a painful hip. Neither of the patients had predisposing factors. Both of them showed hip flexion with limited range of motion in rotations. Confirmation of the diagnosis was made by ultrasound, CT-scan and/or MRI. Needle aspiration of the hip, under general anaesthesia, confirmed the reactive origin of the joint effusion in both patients. In neither of the two cases was there a significant diagnostic delay. Staphylococcus aureus was isolated in the purulent material in one case and in the hemoculture in the other. Both patients have been checked in a long-term revision (follow-up of 7 and 10 years). RESULTS: They were successfully treated by isolated antibiotherapy in one case and surgical drainage in the other. Healing was achieved in each case without relapse or sequels in a long-term revision. We carry out a global revision of this rare infection, emphasising the difficulty of its clinical diagnosis and the different treatment modalities and the proper indication. We suggest an algorithm as a clinical guide for its clinical-therapeutic management.

Anti-Bacterial Agents↗
PubMedDate not supplied

[Spinal tumors in infancy. A report of 48 cases].

INTRODUCTION: Spinal tumours in infancy are an infrequent oncological disorder. The clinical features, usually of insidious onset, are alterations in gait and a painful spine. OBJECTIVE: To analyze the different histological types of spinal tumours seen in infancy and their form of presentation in our series. PATIENTS AND METHODS: We reviewed the clinical histories of 48 patients with intraspinal tumours, aged under 15 years, whose reports of histological diagnosis had been sent to our centre. RESULTS: Of the patients studied, 17 were girls (35.4%) and 31 boys (64.6%) with an average age of 7.7 years. The histological diagnoses made most frequently were astrocytomas (22.9%) and lipomas (18.8%) followed by metastases (12.5%), ependymomas (8.3%) and Edwing's sarcoma (8.3%). The clinical features were present prior to diagnosis for between 1 and 6 months in 13 patients, and for less than one month in 9 patients. The presenting symptoms were alterations in gait and back pain in most patients. Exploratory tests were related to the involvement of long vias and second motor-neurone lesions. The main topographical findings were: in the axial plane the lesions were extradural (23 patients) and in the sagittal plane there was dorsal involvement (34 patients). CONCLUSIONS: Insidious, progressive alterations in gait together with continuous, nocturnal back pain are valuable data when a serious spinal disorder is to be suspected. Early diagnosis should be based on neuroimaging tests, essentially MR, in the patients in whom spinal cord involvement is considered.

Adolescent↗
PubMedDate not supplied

Intracranial pressure in adult non-tumoral hydrocephalus.

Intracranial pressure (ICP) was monitored continuously for 48 hours in four patients with different types of non-tumoral adult hydrocephalus and classificated according to ICP recordings. It is emphasized that ICP monitoring is essential in the diagnosis of normal pressure hydrocephalus (NPH), since its possible to observe abnormal pressure recordings with morphological alterations which can be accompanied or not by periods of raised ICP. It is suggested that this method may help identify cases suitable for surgery.

Adult↗
PubMedDate not supplied

Chlamydial infection in Papanicolaou-stained cervical smears.

Infection by Chlamydia trachomatis was frequently observed in routine cytologic smears studied for cancer detection. Seventy-three smears from 187 Chlamydia-positive cases seen in a two-and-one-half-year period were reviewed to establish the relationship between C. trachomatis infection and the incidence of metaplastic and dysplastic cells. An inflammatory process with metaplastic cells was found in 72.6% of the smears and dysplastic cells in 16.4%. The Papanicolaou stain gave enough detail not only for the identification of the inclusions but also for the relation of different types of inclusions to the different stages of the life cycle of the microorganism.

Adolescent↗
PubMedDate not supplied

[Aortic prosthesis, long-term results and evolution].

The results and evolution of 126 aortic prosthesis implanted from 1964 to 1971 were reported. The results are appraised according to the criteria of the NYHA. The hospital mortality in the first five years was 40%; in those operated on in the following 3 it fell to 21% and finally those treated in the last 2 years had 16%. The delayed mortality was 19%. Depending on the type of valvular lesion, the stenosis have the highest mortality (50%). The group II and II of the NYHA had less mortality. In the evolution of the survivors at ten years, the incidence of actual survivors shows that after the first two years of prosthetic change, the survival rate tends to stabilize staying at 77% at the end of 10 years; of which 75% evolve well and 17% badly. A separate analysis was made of the factors which modify the results and evolution such as calcifications, associated mitraltricuspid lesions, and myocardial damage. The most frequent complications were embolisms 14%, prosthetic dysfunction 12.8%, endocarditis 3.8%, and hemolysis 2.5%.

Adolescent↗