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Biomedical subjects

J Romeu

Publications and source records attributed to J Romeu.

At least 55 records · Page 3Linked to original sources
PubMed1995

[Acute pancreatitis in patients infected with the human immunodeficiency virus].

This study was designed to define the etiological spectrum of acute pancreatitis in patients infected with HIV in our environment and to evaluate the relevance of cytomegalovirus as etiological agent. A retrospective analysis was first made of clinical, analytical, radiological and pathological findings of patients infected with HIV clinically diagnosed of acute pancreatitis (period 1984-1993). Then, clinical records of patients with necropsy proven CMV pancreatic involvement were retrospectively analyzed (period 1985-1992) to evaluate whether they had been diagnosed of acute pancreatitis when alive. Nine cases were diagnosed of acute pancreatitis. A presumptive etiology (didanosine) was considered in seven cases and idiopathic in two. Five patients died, two from causes directly related to acute pancreatitis. Necropsy was performed in two cases. Mortality was associated with the development of renal insufficiency or the appearance of three or more complications (p = 0.039). With regard to the second phase of the study CMV pancreatic involvement was demonstrated in 4 necropsies out of a total of 22 with evidence of CMV infection in one or more organs. None of these patients was diagnosed of acute pancreatitis when alive. Acute pancreatitis is an uncommon entity in patients infected with HIV. Presumptively, it could be attributed to didanosine therapy in most of our cases. The mortality rate was high, particularly when renal failure developed. In no case was CMV involved as etiologic agent when the patient was alive, although necropsy showed that pancreas can be subclinically involved in the context of a CMV disseminated infection.

AIDS-Related Opportunistic Infections↗
PubMed1995

Health record problem-oriented information system.

Health Record refers to the recording of the medical and relevant social history of the patient, obtained directly or indirectly. It is an instrument of frequent use that must guarantee the quality of assistance provided, reflecting all information pertinent to forming the patient's medical history. It must be designed so that data is easily and effectively retrieved for everyday use, without compromising the patient's privacy. The Health Record Problem Oriented model achieves all of these objectives. This model comprises: 1. Initial data: the relevant medical histories and biography is recorded. 2. Problems list: the patient provides reasons why she is seeking medical attention. 3. Performance plans: these include diagnostic, therapeutic, pharmacological, dietetic, physiotherapist, and surgical plans, as well as the education of the patient. 4. Evolution notes: the progress of the condition. This model guarantees multi-professional registration, an integral focus on the health, and a continued focus on the patient. These characteristics make it the model par excellence of Primary Care. Prior to the implementation of this model, existing information must be analyzed so that it can eventually be converted to a relational database. The Entity-Relationship Model (E/R Model) has been used to represent the database. Here, the basic concepts involved are entities, relationships, and attributes. Entities represent classes or objects from the real world that have common characteristics. The relationships represent the aggregation of two or more entities. The attributes are elemental properties of both entities and relationships. The E/R Diagram graphically represents the conceptual model of a database; the one built for the Health Record Problem Oriented reflects all the entities that compound the attending processes and the relationships existing between them. The Patient is the central axis of the attending process. The record contains the identifying data of the subject and his habits. We can know his medical history by means of his past Illness (personal and family record), Vaccine (what he is vaccinated against), and Case History (each patient has a case history). The other important component is the Consult Motive. A patient has a reason for every consultation, and this reason is added to her medical history as part of the Consult Motive. Each consult motive produces different events that are shown as relations with the other entities. So, for example, by analyzing a patient's history of complaints, a doctor can more suitably determine if she should recommend Cardiac or Anthropometric Exploration, request an Analysis, request a Radiography or Specialist Report, or prescribe a Treatment. The various elements that are part of a Consult Motive are expressed as different entities. Once the conceptual schema of the database is defined, the next step is to convert this schema to a logical schema, suitable for the Relational Model.

Medical Records Systems, Computerized↗
PubMed1994

[Cardiac tamponade and Kaposi's sarcoma].

The case of a 31 year-old intravenous drug addict female patient with infection by the human immunodeficiency virus who had recurrent cardiac tamponade and who was diagnosed by pericardic biopsy as Kaposi's sarcoma is reported. The patient demonstrated involvement by cutaneous, mucosal, lymph node and probably pleuropulmonary Kaposi's sarcoma. Thoracic radiography, computerized tomography and echocardiography only showed the presence of pericardic effusion. Neither did the pericardic fluid obtained by pericardiocentesis provide any significant ethiologic data. Only the pericardic biopsy showed the typical lesions of Kaposi's sarcoma in this localization confirming diagnosis. This is the first case of pericardic Kaposi's sarcoma described in an alive patient and the difficulties of achieving the diagnosis of the cardiac involvement by Kaposi's sarcoma in AIDS patients are commented upon.

Acquired Immunodeficiency Syndrome↗
PubMed1993

A distinctive cytologic pattern for diagnosing tuberculous lymphadenitis in AIDS.

Tuberculous lymphadenitis (TL) is a very common infection in human immunodeficiency virus (HIV)-infected patients. We performed fine-needle aspiration biopsy (FNAB) of enlarged lymph nodes in 57 HIV-infected patients to evaluate its usefulness in this population. We observed three cytologic patterns in 21 patients diagnosed as having TL: granulomatous lymphadenitis (GL) in 4 FNABs, necrotizing granulomatous lymphadenitis (NGL) in 7 FNABs, and necrotizing lymphadenitis (NL) in 12 FNABs. GL and NGL are already well-known and considered to be highly suggestive of TL. Our results support the idea that NL should have the same diagnostic value as GL or NGL. In the group of 12 patients with NL, TL was confirmed in 11 by microbiologic methods (7 by a positive Ziehl-Neelsen stain and 4 by a positive Löwenstein culture) and in the remaining patient by a biopsy that showed NGL with acid-fast bacilli. We conclude that FNAB is a useful, inexpensive, and safe technique for diagnosing TL in HIV-infected patients. The finding of a NL pattern is suggestive enough of TL to start antituberculous treatment.

AIDS-Related Opportunistic Infections↗
PubMed1992

[Hepatic changes in patients with isolated immunodeficiency virus infection and AIDS].

BACKGROUND: The aim of the present study was to describe the spectrum of liver disease in isolated infection by the human immunodeficiency virus and in the acquired immunodeficiency syndrome as well as evaluate whether clinical and/or biological data exist to permit specific diagnosis in liver biopsy. METHODS: Liver biopsy was performed in 39 patients with the human immunodeficiency virus (34 via parenteral drug addicts), 22 of whom had established acquired immunodeficiency syndrome. RESULTS: In 29 cases (74%) a specific histologic diagnosis was obtained with the changes most frequently found being the presence of granulomas (11 patients), mainly in patients with stablished AIDS, and chronic active hepatitis non A non B (10 patients), specially in the cases with isolated infection by the human immunodeficiency virus. Obtaining of a specific diagnosis was associated with an increase in GOT and a decrease of the CD4 lymphocytes and the CD4/CD8 quotient (p = 0.002 in all cases). The existence of established AIDS or prolonged fever was associated with the finding of hepatic granulomas (p = 0.02 and p = 0.002, respectively). The increase in GPT, the absence of stablished AIDS and the absence of prolonged fever was associated to the presence of chronic active hepatitis (p = 0.01, p = 0.002 and p = 0.0002, respectively). CONCLUSIONS: In patients with infection by the human immunodeficiency virus liver biopsy provides diagnostic information in a high percentage of cases. The presence of established AIDS, prolonged fever, and hypertransaminasemia may point towards possible histologic diagnosis.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Acute eosinophilic pneumonia due to toxocariasis with bronchoalveolar lavage findings.

A previously healthy young man presented with breathlessness, diffuse pulmonary infiltrates on the chest x-ray film, and a high degree of peripheral blood eosinophilia. Analysis of bronchoalveolar lavage (BAL) fluid showed 64 percent eosinophils. A diagnosis of toxocariasis was eventually reached on the basis of a positive enzyme-linked immunosorbent assay (ELISA) for Toxocara canis. The routine performance of the ELISA test for Toxocara in the diagnostic approach to pulmonary infiltration with eosinophilia could reveal an undetermined, sometimes unsuspected, number of cases of adult toxocariasis with pulmonary involvement. A high degree of eosinophilia in the differential cell count of BAL fluid may eventually prove to be a useful clue in favor of such a diagnosis.

Acute Disease↗
PubMed1991

[Kaposi's sarcoma with primary pulmonary involvement in a parenteral drug addict with acquired immunodeficiency syndrome].

Pulmonary Kaposi's sarcoma (KS) was diagnosed by pulmonary biopsy in a heterosexual parenteral drug abuser (PDA). The patient had previously been diagnosed of Pneumocystis carinii pneumonia and pulmonary tuberculosis. Thoracic computed tomography (CT) showed bilateral nodular lesions which were less apparent in conventional radiological study and which increased in size in spite of correct therapy. As cutaneous lesions suggesting KS subsequently appeared, the possibility of pulmonary KS was considered and confirmed by open biopsy. The rarity of a primarily pulmonary presentation of KS in a PDA, the difficulty in diagnosis owing to concomitant infective diseases and the diagnostic value of thoracic CT for the diagnosis of pulmonary KS are discussed.

Acquired Immunodeficiency Syndrome↗