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Biomedical subjects

J M Martín

Publications and source records attributed to J M Martín.

At least 19 recordsLinked to original sources

[Chondroid syringoma: a clinical and histological review of eight cases].

INTRODUCTION: Chondroid syringoma is a rare skin tumor that presents as a slow growing, indolent lesion, that is more frequent in male adults and is usually benign. It is treated surgically and its diagnosis is histological. It can be classified as eccrine and apocrine according to its pathological characteristics. MATERIAL AND METHODS: Eight cases diagnosed of chondroid syringoma in our Department in the last eight years were reevaluated clinically and histologically and the epiluminiscence microscopy was used in one of them. RESULTS: Most of the cases occurred as well-defined nodular lesions, whose presumptive clinical diagnosis was adnexal or cystic pathology. All were treated surgically. The epiluminiscence microscopy showed a pattern of homogenous whitish-blue coloring. All the cases had a myxoid matrix and most also had a chondroid one. Five of the eight cases were apocrine, one of them with follicular and sebaceous differentiation. DISCUSSION: The chondroid syringoma is usually a small-sized skin tumor, frequently on the head and neck. The dermatoscopy does not seem to supply any specific trait to this lesion. The microscopic examination of these lesions reveals tubuloalveolar and glandular type structures positioned as islets within a fibroadipose, chondroid, myxoid or hyaline stroma. The final treatment of these tumors is surgical. As a general rule, it is a benign tumor. Some authors have proposed the term of atypical mixed tumor of the skin for those chondroid syringomas with histological traits of malignancy but without evidence of metastasis.

Adenoma, Pleomorphic↗

[Necrotizing subcutaneous infection by Streptococcus agalactiae].

Necrotizing soft tissue infections constitute some of the most potentially threatening infections that may be acquired in the community or in the hospital milieu as they are associated with a high mortality rate. In most cases they are produced by Streptococcus pyogenes. We report a case of a necrotizing soft tissue infection caused by Streptococcus agalactiae (group B beta hemolytic streptococcus) that involved the leg of an elderly man with chronic lymphatic leukemia and diabetes mellitus. The lesions notably improved after initiating intravenous antibiotic treatment with amoxicillin-clavunate and clindamycin.

Aged↗

Cutaneous plasmacytosis associated with lung and anal carcinomas.

Cutaneous plasmacytosis is a rare disorder characterized by a benign proliferation of mature plasma cells that appears as multiple dark-brown to purplish skin lesions, often associated with polyclonal hypergammaglobulinaemia. We present the case of a 55-year-old Caucasian man who suffered from a cutaneous plasmacytosis associated with two different carcinomas. Cutaneous plasmacytosis seems to be a reactive process because most cases reported are not associated with any apparent underlying disease. Nevertheless, because few reported cases were associated with malignancies, screening of additional neoplasms would be justified.

Anus Neoplasms↗

CD4+/CD56+ haematodermic neoplasm: a preculsor haematological neoplasm that frequently first presents in the skin.

CD4+/CD56+ hematodermic neoplasm, formerly known as blastic NK cell lymphoma, is an aggressive and rare preculsor hematologic neoplasm recently recognized by the WHO-EORTC classification consensus for cutaneous lymphomas. The neoplasm tends to affect elderly patients, who usually present with skin lesions but often have a disseminated disease, including bone marrow involvement. Although the lesions are composed of cells with a lymphoblast-like morphology and an NK-cell phenotype, exhibiting a CD4+, CD56+ positive immunophenotype, recent studies support a relationship to plasmacytoid dendritic cells. Because of the rarity of this disease, we describe two patients suffering a CD4+/CD56+ hematodermic neoplasm.

Aged↗

Adal-1 bioadhesive for sutureless recession muscle surgery: a clinical trial.

AIMS: To evaluate the efficacy and biotolerance of the Adal-1 adhesive for muscle sealing in strabismus surgery. METHODS: 27 eyes were included in the study: 17 in the control group and 10 in the study group. Surgery was performed on the recession of the horizontal rectus muscles. In the control group the muscle was joined to the sclera by a Vicryl 7/0 suture. In the study group, the Adal-1 adhesive was used instead. The efficacy of the sealing of the muscle to the sclera and the biotolerance of the surrounding tissues were evaluated. RESULTS: The muscular recession in the control group was 8.17 (SD 2.38) with displacement of the sealing point of 0.02 (1.7) mm. In the group sealed with adhesive, the muscular recession was 9.09 (3.08) and the displacement was 0.15 (1.56) mm, with no significant differences between the techniques (p<0.05). The inflammation of the surrounding tissues in the immediate postoperative period was greater with the suture technique (p>0.05), but there were no differences in the other postoperative periods (Mann-Whitney U test). CONCLUSION: Adal-1 was an effective and safe alternative to sutures in muscle recession for strabismus surgery in this study.

Acrylates↗

[Neuropsychological impairment in patients with intracranial aneurysms: surgical versus endovascular treatment].

OBJECTIVES: To describe the neuropsychological status of patients with intracranial aneurysms and to compare the cognitive status of patients with intracranial aneurysm treated by surgical or endovascular methods. MATERIAL AND METHODS: Ninety-three cases with intracranial aneurysms treated with surgery (n = 56) or embolization (n = 37) were included. A neuropsychological assessment was applied to both groups retrospectively, at least one year after treatment. RESULTS: Neuropsychological impairment was found in both groups. 35.7% of the patients treated with surgery and 43.2%, of those treated with embolization did not show any cognitive impairment. Visual Memory and Cued Recall of verbal information are better in patients treated by embolization. CONCLUSIONS: Our results show that a large proportion of patients with intracranial aneurysms have cognitive impairment after treatment. Endovascular management may cause less impairment in visual and verbal memory. However, bleeding may be the most important factor to explain these cognitive impairments.

Adult↗

Clinicopathological and immunohistochemical analysis of 20 cases of Merkel cell carcinoma in search of prognostic markers.

AIMS: To evaluate the clinicopathological and immunohistochemical characteristics of Merkel cell carcinoma (MCC) in an attempt to find new, potentially significant, prognostic markers. METHODS AND RESULTS: Clinical data and follow-up, histopathological features (pattern, cell size, thickness, mitoses, vascular invasion, lymphocytic infiltration) and immunohistochemical detection [CK20, thyroid transcription factor (TTF-1), chromogranin A, synaptophysin, p53, Ki67, Fli-1, CD99, c-Kit] were evaluated in 20 cases of MCC. Fli-1 and CD99 were detected in 90% and 55% of cases, respectively. Tumour size>30 mm, stage II, 'absent' lymphocytic infiltration, and the presence of>50% of Ki67+ tumour cells, were found to be prognostic indicators of disease-free interval (DFI), but only 'absent' lymphocytic infiltration constituted an independent prognostic factor of DFI after multivariate analysis. For overall survival, the same variables, together with local recurrence and lymph node involvement, had prognostic significance, with only local recurrence as an independent prognostic factor after multivariate analysis. CONCLUSIONS: Absence of lymphocytic infiltration and Ki67 immunoreactivity in more than 50% of tumour cells should be evaluated in conjunction with other well-known prognostic markers in MCC. Furthermore, recognizing that Fli-1 and CD99 expression is commonly found in MCC by immunohistochemistry may avoid misinterpretation in the differential diagnosis of MCC with other small round cell tumours.

12E7 Antigen↗

An amalgam tattoo on the oral mucosa related to a dental prosthesis.

A 60-year-old woman presented with a pigmented lesion on the upper left gingival mucosa of 2 years duration. The lesion was in an area where a dental metallic prosthesis had been inserted into a nearby tooth several years earlier. A biopsy of the affected mucosa showed aggregates of pigmented granules varying in size in the dermis, extracellular matrix and within macrophages; these did not stain with melanin stains. The diagnosis was consistent with an amalgam tattoo.

Biopsy↗

Clinico-pathological analysis of the cutaneous lesions of a patient with type I pseudohypoaldosteronism.

The autosomal recessive form of type I pseudohypoaldosteronism (PHA-I) is an unusual disorder characterized by aldosterone resistance at the target organs, which leads to an excessive loss of sodium chloride through urine, sweat and saliva, among other secretions. Such a high concentration of salt in the sweat during the depletive crises directly causes inflammation and damage in the eccrine structures, with cutaneous lesions similar to those appearing in miliaria rubra. We report an autosomal recessive PHA-I in a 4-year-old girl, with cutaneous lesions mimicking miliaria rubra, that improved after treatment with astringent solutions and avoidance of profuse sweating.

Child, Preschool↗

Linear accelerator radiosurgery in treatment of central neurocytomas.

OBJECTIVES: The purpose of this report was to review our experience with stereotactic radiosurgery in the management of patients with residual neurocytomas after initial surgery. METHODS: Between October 1996 and December 2001, four patients with central neurocytoma were treated by surgery and subsequently underwent linear accelerator (LINAC) radiosurgery. RESULTS: Two of the patients were cured, one exhibited a significant reduction in tumour size and the fourth remains stable. All four patients are alive and well. CONCLUSIONS: In cases of small residual tumours or recurrences radiosurgery allows open surgery to be avoided and is a safe and potentially effective approach.

Adult↗

Organ donation and family decision-making within the Spanish donation system.

This study analyses the variables associated with the decisions made by families of potential organ donors to give or deny consent for the extraction of organs. Different indicators were recorded in 68 cases of family interview for petition of consent carried out in 13 Spanish hospitals. Those variables showing the strongest relation with family decision (donation/refusal of consent) are knowledge shown by the family about the deceased's wishes with regard to donation (p<0.001), family relationship climate (p<0.01), expression of family's satisfaction level with medical attention received (p<0.01) and number of relatives present at the consent request interview (p<0.01). Logistic regression on family decision with considered variables correctly predicted relatives' final choice in 98.4% of cases. In turn, multivariate exploratory analysis highlights a potential association between the expression of the deceased's wishes and several concurrent variables in the process (satisfaction with personal treatment and medical attention received, emotional reactions in the interviews of notification of death and consent request). It also shows that patterns of reaction and family participation in this process may vary according to the sex of the deceased relative. Results suggest that both educational efforts devoted to promoting a positive attitude toward donation in the general population and the training of health professionals involved in the generation of organs may be key factors in reducing organ shortage.

Bereavement↗

Neurobehavioural and cognitive profile of traumatic brain injury patients at risk for depression and suicide.

The possibility that patients who have suffered a traumatic brain injury will commit suicide is high, and in many cases clinicians tend to underestimate this possibility. In this study, 39 consecutive patients are studied through a Rorschach technique more than 1.5 years after their hospital discharge. The data show that 48.6% of the patients fulfil the criteria that classifies them as depressive, and, of these, 65% are at clinical risk to commit suicide (33.3% of the total of TBI patients); 25.6% have not met the criteria of depression or suicidal tendencies, and another 25.6% show very low suicide tendency scores. Only 15.6% of the total patients presented only depression without risk of suicide. The neurobehavioural and cognitive profile of the TBI suicide-prone patient shows an emotional person with cognitive difficulties in how they interpret reality, the person tries to understand what is happening around them, but is unable to cope. They show concrete thoughts, although they have difficulties solving problems and have few intellectual resources to cope with their surroundings. They do not know how to distance themselves from the emotional aspects of situations.

Adult↗

An exploratory multivariate approach to drug consumption patterns in young people based on primary socialization theory.

Drug consumption patterns and their psychosocial conditioning factors are explored on the basis of Primary Socialization Theory (PST), through the application of a questionnaire to a representative sample (N= 650) of the young population (age 15 to 29 years) in the Madrid Region. Cluster analysis identifies five consumption groups. Discriminant analysis, including indicators about subject's integration in primary socialization environments, beliefs about the effects of drugs, indicators of psychosocial wellbeing, and variables related to leisure time, allows 67.45% of correct consumption group prediction. Complex associations between drug use, socialization environments and psychosocial wellbeing are found, calling into question approaches establishing cumulative or unidimensional relationships between posited "risk factors" and drug consumption.

Adolescent↗

Immunohistochemical localisation of rabbit haemorrhagic disease virus VP-60 antigen in early infection of young and adult rabbits.

This study evaluated the time course distribution of rabbit haemorrhagic disease virus (RHDV) structural protein VP60 in tissues from experimentally infected rabbits from three different age groups. Viral VP60 antigen could not be detected in tissue samples from animals under four weeks, and only a few hepatocytes (0.01 to 0.2 per cent) were stained in the 6-week-old animals. A 6-week-old rabbit euthanised at 72 hpi showed VP60-labelling in hepatocytes and macrophages close to areas of inflammation. Viral VP60 antigen was detected as early as 12 hpi in a few hepatocytes (0.03 per cent) from adult animals. Within this age group, the extent of hepatocyte labelling considerably increased at 18 (3.0 per cent), 24 (25.5 per cent), 36 (50 per cent) and 48 (60 per cent) hpi. Extrahepatic viral VP60 antigen was also detected at 36 and 48 hpi in spleen macrophages and lymphocytes from adult rabbits. These findings support the hypothesis that the hepatocyte is the only cell type in the liver able to support RHDV replication almost immediately after viral infection.

Animals↗