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Biomedical subjects

J Juliá

Publications and source records attributed to J Juliá.

13 recordsLinked to original sources
PubMed1999

[Usefulness of photoplethysmography and indexes of digital pressure in Raynaud phenomenon].

BACKGROUND: To know the usefulness of plethysmography and digital pressure indexes (DPI) to assess the vasospasm and the response to medical treatment in patients with Raynaud's phenomenon. PATIENTS AND METHODS: During a four-month period, we carried out a prospective clinical trial, with a control group (15 subjects) and other of patients with Raynaud's phenomenon (40 patients). We calculated the digital pressures, plethysmography and the DPI, in basal status and after provocation with cold water. The Raynaud's group was divided randomly in two homogeneous subgroups of 20 subjects. One of the groups underwent treatment with calcium antagonists and the other group with placebo. These determinations were repeated at the middle and at the end of the treatment. RESULTS: The basal DPI and after provocation test were lower in the Raynaud's group (0.61 [SD 0.26] and 0.25 [SD 0.26]), than in the control group (0.93 [SD 0.06] and 0.88 [SD 0.07]), with a statistical significance (p < 0.001 and p < 0.0001). After the treatment, in the subgroup treated with calcium antagonists, the DPI were increased in a statistically significative way respect to those in the placebo subgroup (p < 0.0001). Sensitivity and specificity of the DPI associated to the provocation test were of 97 and 93%, respectively. The plethysmographic wave did not suffer significant variations; sensibility and specificity were 48 and 100%. CONCLUSIONS: In the Raynaud's phenomenon the DPI associated to the provocation test have a high sensitivity and specificity, and allows determination of the degree of vasospasm and the response to treatment.

Adult↗
PubMed1999

Determinants of left ventricular mass in untreated mildly hypertensive subjects: hospitalet study in mild hypertension.

The objectives of this cross-sectional study were to identify the determinants of left ventricular mass in untreated mildly hypertensive subjects at the Hypertension Unit, Department of Internal Medicine, Red Cross Hospital, Hospitalet de Llobregat, Barcelona, Spain. One hundred seventy-one untreated mildly hypertensive subjects, with a mean age of 41.1+/-11.8 years (from 18 to 65 years) were sequentially visited in our Unit; 54% were men. Echocardiographic measurements of good quality were obtained in 142 subjects (83%). Two-dimensional guided M-mode echocardiograms were used and left ventricular mass was estimated according to the Penn convention. Left ventricular mass (LVM) was analyzed as a continuous variable. In the bivariate analysis, the variables that significantly correlated with LVM were patient's height (r = 0.42, P<.0005), weight (r = 0.47, P< or =.0005), heart rate (r = -0.22, P = .01), HDLc (r = -0.30, P = .002), hematocrit (r = -0.28, P = .001), urinary sodium excretion (r = 0.23, P = 0.012), and different measurements from the ambulatory blood pressure profile for 24 h. By means of multiple regression analysis, a maximum of 41.2% of LVM variability could be explained from the factors registered in our study. The final model included age, gender, patient's weight, and diastolic night load from ambulatory blood pressure monitoring. When added to different models, weight and diastolic night load showed a similar strength in predicting left ventricular mass. In untreated patients with mild hypertension, traditional factors such as blood pressure levels explain a maximum of 41.2% of LVM variability. More knowledge is needed about factors that may alter cardiac morphology in the evolution of hypertensive patients.

Adolescent↗
PubMed1999

Acute ischemia of the lower limb. An unusual complication of Paget's disease of bone.

Paget's disease of bone (osteitis deformans) is one of the most common skeletal diseases, characterised by bone distortion and the loss of interior structure. Asymptomatic evolution is usual, so diagnosis is likely to be made only when complications of the disease appear. This paper describes such a diagnosis made in a patient with acute lower limb ischemia caused by the compression of the superficial femoral artery between the adductor muscles and an exostosis of the femur.

Aged↗
PubMed1995

[An aneurysm of the inferior mesenteric artery associated with obstruction of the superior mesenteric artery and the celiac trunk].

The exact prevalence of visceral arteries aneurysms is not well documented and its is mainly known from necropsies. Inferior mesenteric artery aneurysms are the rarest of visceral aneurysms. The authors report a case of an aneurysm of the inferior mesenteric artery in a 52-year-old man with obstructive disease of superior mesenteric artery and celiac axis. The diagnosis was made by angiography. The aneurysm was resected with superior and inferior mesenteric arteries revascularization. Surgical approach is needed in these aneurysms and when they are associated with obstructive disease of other intestinal artery, revascularization is mandatory.

Aneurysm↗
PubMed1994

[Aneurysm of the celiac trunk associated with infrarenal aortic and popliteal artery aneurysm].

Intestinal artery aneurysms are usually asymptomatic; however when rupture occurs, mortality rates of up to 75% have been reported. Celiac artery aneurysms are quite infrequent, only about 4% of all visceral aneurysms; their association with Aortic Aneurysms is found in 18% of cases; their association with popliteal aneurysms has not been documented so far. A case of an adult male with celiac artery aneurysm associated with Aortic and Popliteal Aneurysms is reported. The patient was operated. In a first procedure the celiac and aortic aneurysms were resected, an aortic graft was placed, and hepatic artery reimplantation was performed; in a second procedure the popliteal artery was resected and a vascular reconstruction performed. The postoperative course was uneventful, and the patient remains asymptomatic two years later. Diagnosis was based on a CT scan with selective visceral angiography. Elective surgical intervention must be performed when intestinal artery aneurysms are discovered.

Aneurysm↗
PubMed1984

Breast cancer screening of the high risk population with clinical examination and thermography. A combination of telethermography and plate thermography.

On a total of 2523 patients, including the High Risk group, a breast screening was made by clinical exploration and Thermography used as a selective method for the cases due for a Mammography. Although the electronic thermographic examination was done according to the criteria established by the School of Marseilles, we excluded from these criteria the vascular asymmetry test. Such a controversial parameter was substituted by the data given by the angiographic analysis of contact thermography. The results obtained were compared to those referenced in a previous study. The analysis of the compiled data indicated that even if we weren 't the sensitivity of the technique, we did get improvements diagnosing less false positive results with the new procedure (91.43%) than with the previous study (87.65%) (p less than 0.001). The predictive Value (+) was 0.4133 in the present group against the previous 0.10, which meant that 41.33% of the cancers diagnosed were true cancers, against 10% in the previous group. Summing up the analysis showed a higher rate of positive global detections (p less than 0,0005) with our present analytic criteria for Thermography.

Breast Neoplasms↗
PubMed1978

Concealed atrial electrical activity.

In the following paragraphs we describe a case diagnosed clinically and haemodynamically as a cardiomyopathy. Atrial flutter which was not in evidence in the standard ECG was diagnosed by the use of a new technique of amplification and filtering of special surface leads (T.A.F.). The diagnosis was later confirmed by means of special internal techniques (intra-atrial ECG and His bundle recording). The existence of a subpraventricular rhythm, probably sinusal, and also unapparent in the standard ECG, was observed by using the same method after electrical defibrillation. We comment on the extreme rareness of discovering concealed atrial rhythms and their possible explanation, and we emphasize the usefulness of the T.A.F. technique in their diagnosis.

Adult↗
PubMedDate not supplied

[Clinical management in an angiology and vascular surgery unit. Results of the application of a clinical practice protocols].

OBJECTIVES: The aim of this study was to analyze the impact of clinical management on quality indicators in a vascular surgery unit over a 10-year period. METHODS: We performed a retrospective analysis of quality indicators from 1990 to 2001 and of the influence of a clinical practice protocol and standards of quality on these indicators. RESULTS: Comparison of both periods revealed improvement in all the quality indicators. The safety of surgical procedures was unaffected by the application of management protocols and clinical pathways. CONCLUSIONS: Clinical management based on the cost-quality binomial can ensure the efficiency of a hospital unit without adversely affecting quality of care. Quality standards based on hospital resource use, morbidity and mortality can be defined for groups of procedures.

Algorithms↗