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Biomedical subjects

J L Castillo

Publications and source records attributed to J L Castillo.

45 records · Page 3Linked to original sources
PubMed1989

[Multiple sclerosis in health care in our country: electrophysiological, immunological and clinical analysis].

Among 70 patients referred for suspected multiple sclerosis (MS) a total of 40 met criteria for definite (17), likely (12) or possible (11) diagnosis of the disease. Visual evoked potentials provided evidence of CNS lesion in 13 cases. Abnormalities of somatosensory evoked potentials, particularly on stimulation of the posterior tibial nerve, were present in 90% of patients. Brainstem auditory evoked potentials were of little use, contributing to diagnosis of one subclinical lesion; they were normal in 14 cases with suspected brainstem involvement. A definite diagnosis of MS was made in 4 cases by study of oligoclonal bands. The most frequently involved sites were the optic nerve and the brainstem, followed by the spinal cord. Hemispheral location was demonstrated in only 3 cases. These findings of the first study on MS in our country suggest a different pattern for demyelinating diseases in Chile.

Adult↗
PubMedDate not supplied

[Diagnosis of common causes of vertigo using a structured clinical history].

The structured clinical history is the most sensitive test for diagnosing vertigo. Its diagnostic effectiveness on the first visit was analyzed and key signs and symptoms with high predictive value for common causes of vertigo were identified. One hundred outpatients who complained of dizziness or loss of balance were evaluated using a structured clinical interview. Each questionnaire was examined independently by three blinded investigators, who assigned a diagnosis and identified the elements of the history that figured most prominently in the diagnosis. The gold standard was defined as independent selection of the same diagnostic category by all three investigators. A first-visit diagnosis was obtained in 40% of patients (95% confidence interval 30-50%): 38% women and 42% men. Causes included benign positional paroxysmal vertigo (BPPV, 13 patients), headache-associated vertigo (9), Meniere disease (7), cervical vertigo (3), psychiatric dizziness (2), post-traumatic vertigo (2), vertebro-basilar transient ischemic attack (1), vestibular neuritis (1), convulsive seizure (1), and presyncope (1). The best predictors of BPPV were the precipitating mechanism (specificity [SP] 100%), positional nystagmus (sensitivity [SE] 90%, SP 63%), and the Dix-Hallpike test (SE 82%, SP 71%). Elements predictive of headache-associated vertigo were duration of the attack (minutes) and a personal history of headache (both, SP 100%). Other predictors were facial hypoesthesia (SE 92%, SP 47%) and associated neurological disease (SE 82%, SP 58%).

Adult↗
PubMedDate not supplied

[Diagnosis and treatment of sensorineural hearing deficits of autoimmune origin].

Sensorineural hearing loss (SHL) of autoimmune origin is characterized by a rapidly progressive onset. Diagnosis is difficult and the condition responds to corticoids or immunosuppressant agents. Two cases with an onset over weeks and progressive hearing loss are reported. Both patients had SHL associated with another autoimmune disease. Laboratory findings were abnormal (immunoglobulins and lymphocyte populations), suggesting an immune disorder. Treatment with 1 mg/kg/day of deflazacort restored hearing to normal. Both patients are currently asymptomatic. The clinical and laboratory response of patients to deflazacort supported the diagnosis of autoimmune SHL.

Adult↗
PubMedDate not supplied

[Coronary dissection following coronary radiography].

We present 4 cases of dissection of the coronary arteries during coronary radiography, which required emergency surgery. The right coronary was dissected in 2 cases and the left coronary in the remaining cases. Coronary artery bypass was carried out using saphenous vein. Although one patient suffered myocardial infarction, all patients had successful recovery and evolution.

Adult↗
PubMedDate not supplied

Post-coronariography dissection of the right coronary artery.

The case of a patient undergoing an emergency aortocoronary bypass to the right coronary artery after its acute dissection at coronariography is presented. Surgery was carried out two hours after the incident. After successful recovery and postoperative study, it was concluded that the main technical problem posed by this operation which was whether or not to ligate proximally the right coronary was satisfactorily solved by the initial decision not to ligate it.

Adult↗
PubMedDate not supplied

Design of a laminar flow chamber to study platelet aggregation.

The growing importance of the utilization of artificial materials in cardiovascular surgery makes it necessary to know their thrombogenic capacity. Our flow chamber, which is constructed of methacrylate, is capable of providing a laminar flow. The chamber itself consists of the trunks of two cones, one for the inflow and the other for the outflow, which are joined at their widest point to the ends of a cylinder of the same diameter. In the interior of the cylinder, which constitutes the central part of the system, are placed three rectangular fragments of the material to be studied. The vertices of the trunks of the cones allow the coupling of two flexible siliconized tubes in such a way that the system can be utilized in an "ex vivo' experimental model, constituting a bridge between the femoral artery and the right atrium of a large experimental animal, as well as in vitro, coupled to a continuous perfusion pump. The advantages provided by this system are that: (a) three materials can be studied simultaneously in an identical situation, (b) it is possible to submit these materials to conditions similar to those that give rise to platelet thrombi, and (c) it is possible to quantify the aggregation on each material by labelling the platelets with 111In-oxine.

Biocompatible Materials↗