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J Lahuerta

Publications and source records attributed to J Lahuerta.

At least 19 recordsLinked to original sources
PubMed1999

Report of an image quality and dose audit according to directive 97/43/Euratom at Spanish private radiodiagnostics facilities.

An audit of Spanish private medicine radiodiagnostics facilities has been carried out, based partly on Spanish legislation relating to European Directives on health protection against ionizing radiation risks in medical exposure. The study included an appraisal of infrastructure and equipment, and aspects of quality assurance and radiation protection, by means of data collected through surveys. Of the 51 centres audited, a sample of 24 X-ray rooms was chosen, then an external evaluation with regard to image quality and patient dose was performed, by an advisory board of radiologists and medical physicists. The methodology used was similar to that of the group of European Union experts in European dose evaluation and image quality trials. Chest, abdomen, lumbar spine and breast examinations were monitored. Doses were measured with thermoluminescent dosimeters. A third of the X-ray rooms evaluated reached or exceeded dose reference values, and in a third of the cases the image quality left considerable room for improvement. Breast and chest examinations showed themselves to be the hardest to perform, not only as a result of exceeding the reference doses, but also due to failure to meet good image quality standards.

European Union↗
PubMed1998

Favorable prognosis after late relapse of Hodgkin's disease.

BACKGROUND: Most relapses of Hodgkin's disease (HD) occur within the first 2 years after diagnosis, but they may develop after a longer observation period. The aim of this study was to define the incidence, clinical course, and prognostic factors for late relapse (LR) of Hodgkin's disease. For this purpose, the authors defined LR as relapse that occurred in patients who achieved a complete remission that lasted a minimum of 24 months. METHODS: During the years 1974-1994, 375 patients with newly diagnosed HD were treated at out institution. Of these patients, 223 remained free of disease for at least 2 years. In addition, 26 patients had been in complete remission for a minimum of 24 months after salvage treatment. Thus, 249 patients were identified as being at risk of LR, and they were the study subjects. The median age was 29 years. Fifty-nine percent of the patients had early stage disease (Stage I/II), and 48% underwent staging laparotomy. Ninety patients presented B symptoms at diagnosis, and 87 had bulky disease. Treatment consisted of radiotherapy for 68 patients, chemotherapy for 68, and combined modality therapy for 113. RESULTS: With a median follow-up of 125 months (range, 22-287 months), the authors observed LR in 25 patients (10%). The estimated relapse rate at 15 years was 13.4%. Relapse occurred after a median disease free interval of 45 months (range, 25-113 months), and it involved sites of previous disease in 70% of the patients. Age > 30 years and treatment with radiotherapy alone were the only significant independent predictors for an increased risk of LR. At a median of 79 months (range, 6-168 months) after therapy for LR, 20 patients were still alive and free of disease (1 of them after rescue treatment for second relapse), and 5 had died (3 of HD, 2 of second tumor). The estimated overall survival (OS) after LR was 82% at 8 years. OS was not significantly different for LR patients than for those who did not relapse. CONCLUSIONS: The actual incidence of LR emphasizes the need for continuous follow-up of patients treated for HD. LR, if properly managed with conventional therapy, does not compromise survival.

Adult↗
PubMed1994

Percutaneous cervical cordotomy: a review of 181 operations on 146 patients with a study on the location of "pain fibers" in the C-2 spinal cord segment of 29 cases.

The authors present a review of 146 patients who underwent 181 percutaneous cervical cordotomies for intractable pain. In addition, an anatomical-clinical correlation was carried out for 29 of these patients. It was found that the fibers subserving pain sensation in the C-2 segment lie in the anterolateral funiculus between the level of the denticulate ligament and a line drawn perpendicularly from the medial angle of the ventral gray-matter horn to the surface of the cord. The best analgesic results have been obtained by creating lesions that extend 5.0 mm deep to the surface of the cord and destroy about 20% of the hemicord. There is a somatotopic organization with sacral fibers running ventromedially and cervical fibers running dorsolaterally. The authors believe that the ascending fibers subserving the distinct sensations of pain induced by tissue damage and pinprick, although mixed (overlapping) in the anterolateral funiculus of the spinal cord, are physiologically distinct from one another. Whereas some cordotomies, both in the current series and as reported in the literature, may affect these functions differentially, optimum pain relief seems to be obtained only when pinprick sensation is also abolished in the affected segments. Evoked pain sensation is not abolished by cordotomy, but its threshold is greatly raised. When pathological pain is completely abolished, so is pinprick sensation. However, in a number of cases where pathological pain was only partially alleviated, pinprick sensation remained intact. The significance of these and other cases reported in the literature is discussed. The importance of clinically distinguishing between pain caused by tissue damage and pinprick sensation is emphasized, as well as that between return of pre-existing or new tissue-damage pain and painful dysesthesia.

Adult↗
PubMed1992

The location and function of respiratory fibres in the second cervical spinal cord segment: respiratory dysfunction syndrome after cervical cordotomy.

After high cervical percutaneous cordotomy for pain in malignant disease, 12 patients died during sleep at postoperative intervals between 1 and 8 days. Nine died after a first cordotomy and three after a second (contralateral) procedure. All except one had known pulmonary disease before operation. The operated segment of the spinal cord (C2) was studied histologically after death. Superposition of lesion outlines made it possible to determine those parts of the lesioned areas common to all unilateral and bilateral cases respectively. All cases dying of presumed respiratory dysfunction syndrome had lesions involving the region of the anterolateral funiculus in the C2 segment containing "pain" fibres activated from the second to fifth thoracic dermatomes. The fibres whose destruction appeared to be responsible for respiratory dysfunction syndrome were completely intermingled with ascending "pain" fibres. The possibility of these fibres being afferent in function is discussed.

Aged↗
PubMed1986

Inhibition of jaw-closing muscles by electrical stimulation of the ophthalmic division in man.

High-intensity stimulation of the supraorbital region elicits, together with a blink reflex, a reflex inhibition of the jaw-closing muscles in normal man. The response differs from the well known inhibition obtained by intra- and perioral stimulation in two main features. Firstly, it consists of a single late silent period (SP), only occasionally preceded by a short and partial decrease of the background EMG activity; secondly, the inhibitory response appears at a rather high threshold, requiring a stimulus intensity which is 4-fold the sensory perception threshold and 3-fold that required to evoke the blink reflex. Electrical and mechanical stimulation of the cornea failed to evoke a significant inhibitory reflex. The silent period and the blink reflex were similarly affected by local anaesthetic infiltration of the supraorbital skin, suggesting that the afferents subserving the two reflexes belong to the same fibre group; the higher threshold of the supraorbital inhibitory response may be explained by the need for a larger spatial summation. The considerable latency gain and relatively rapid habituation shown by the supraorbital inhibitory response imply a multisynaptic circuit, similar to that responsible for the second silent period which occurs following 'oral' stimulation. A common interneuronal net for these two reflexes is suggested by the results of interaction experiments employing combined supra- and infraorbital stimulation.

Adult↗
PubMed1986

Assessment of cancer pain by the McGill Pain Questionnaire: results of two scoring methods in a sample of British patients and comparison with previous studies.

Pain experienced by 29 British cancer patients was evaluated by the McGill Pain Questionnaire. The questionnaires were analysed according to the traditional and a newly proposed scoring method. The results were compared with previously published studies. Scores relating to the sensory and affective components of pain were found to be similar for all groups of cancer pain patients. On the contrary, differences between groups were found for evaluative scores of the overall experience of pain. A previously observed pattern of pain intensity-complexity correlation in cancer pain patients was reproduced. Interpretations of the similarities and discrepancies among groups of patients are discussed.

Affect↗
PubMed1985

Pain laterality in relation to site of pain and diagnosis.

A retrospective study of pain laterality was performed on a sample of 1006 patients suffering from chronic pain attending the Centre for Pain Relief, Walton Hospital, Liverpool, U.K. 769 patients reported unilateral pain. There was no significant difference in the numbers presenting with right-sided and left-sided pain. When the data for different sites of pain were analysed separately a similar picture emerged. No statistically significant differences in the frequency of left- and right-sided pain were found at any site. Similarly, when the data for different diagnoses were examined, there were no significant differences in the laterality of the pain found in any diagnostic category. This study fails to support the general hypothesis that pain, when lateralised, occurs more frequently on the left.

Chronic Disease↗
PubMed1985

Percutaneous radio frequency gangliolysis in the treatment of trigeminal neuralgia.

37 procedures were carried out in 32 patients with trigeminal neuralgia who were unrelieved by anticonvulsants. Initial relief was achieved in 31 patients (98%). 5 patients (16%) suffered a relapse during a follow-up period of 15-26 months. Corneal anaesthesia occurred in 6 patients, 1 of whom subsequently developed a corneal ulcer. Anaesthesia dolorosa appeared in 5 patients. Ipsilateral reduction in hearing was reported by 2 patients. Despite its limits and complications percutaneous radio frequency gangliolysis is an effective alternative in the treatment of trigeminal neuralgia.

Aged↗
PubMed1985

Percutaneous cervical cordotomy: results and complications in a recent series of 100 patients.

One hundred and twenty-two percutaneous cervical cordotomies were performed in 100 patients. Of these, 95 suffered from pain associated with malignant disease. Complete pain relief was achieved in 64% of patients, partial relief in 23% and no relief in 13%. Mortality was 6% and exclusively related to postoperative respiratory dysfunction. The results and complications observed in this recent series are discussed in relation to our previous and other authors' experience. For selected patients with cancer pain, percutaneous cordotomy is the most effective operative method available at the present time.

Adult↗
PubMed1984

Changes in the concentration of somatostatin and substance P in the cerebrospinal fluid following injection of alcohol into the pituitary gland.

The concentration of immunoreactive somatostatin and Substance P in the cisternal cerebrospinal fluid (CSF) of patients with pain due to malignant disease has been measured before and after injection of alcohol into the pituitary fossa. Following the first injection, a rise of 108 +/- 66% in CSF somatostatin levels was observed in 7 out of 13 patients, and a rise of 87 +/- 26% in 4 out of the 5 patients undergoing a second injection. A rise of 179 +/- 99% in levels of Substance P in CSF was observed in 4 out of 8 patients after a single injection. No change in peptide concentration was detected in peripheral plasma. Changes in CSF levels did not correlate with the degree of pain relief obtained, but patients with the greatest increase in somatostatin subsequently developed diabetes insipidus. The data are consistent with our previous experience that injection of alcohol into the pituitary fossa can cause destruction to nervous tissue, in addition to the obvious destruction of pituitary gland tissue. They do not support the suggestion that hypothalamic damage is necessary in order to obtain pain relief.

Ethanol↗