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Biomedical subjects

J Zapatero

Publications and source records attributed to J Zapatero.

At least 19 recordsLinked to original sources
PubMed1996

[The treatment of tracheobronchial ruptures: a review of 6 cases].

Tracheobronchial ruptures represent a serious pathology difficult to diagnose at the first examination. The authors review 6 cases: four as acute types with pneumomediastinum, pneumothorax and subcutaneous emphysema with a delay in diagnosis of 3.25 days, meanwhile 2 cases were chronic forms with a delay in diagnosis of 124.5 days. Diagnosis should be performed as soon as possible based in the presence of uni or bilateral pneumothorax with pneumomediastinum being confirmed by fiber bronchoscopy. The treatment is based in the resection of the fractured fragments, followed by bronchoplasty always with reabsorbable sutures the most frequent surgical technique, meanwhile in the atelectatic forms it is not possible to perform sometimes and we must practise lung resections.

Accidents, Traffic↗
PubMed1995

Bronchovascular mucormycosis: an urgent surgical problem.

The case of a 70-year-old male with lymphoblastic leukemia is reviewed, who presented the rare and almost always fatal complication of pulmonary mucormycosis, but who was treated satisfactorily with amphotericin B and surgery. The risk of massive hemoptysis in the course of mucormycosis that invades the lung vessels, makes us believe that surgery is an essential part of the management of this disease. It is suggested that the patient be operated as soon as the diagnosis is obtained, as we did in our case, to avoid other risks in combined management with amphotericin B.

Aged↗
PubMed1995

[Therapeutic alternatives in complicated nonsurgical pulmonary aspergillomas].

We present 2 patients with pulmonary aspergilloma complicated by massive hemoptysis who were not good candidates for surgery and were treated with intracavitary amphotericin B after arterial embolization failed. In spite of the size of the mycetomas, response to treatment was excellent with full regression of the aspergilloma after 3 to 4 weeks; precipitins to Aspergillus fumigatus became negative and the fungus disappeared from transcatheter aspirate samples. Massive hemoptysis was controlled with epsilon-amino-caproic acid instilled by catheter. No complications were observed, the treatment was well tolerated and no recurrence occurred over a follow-up period of 24 and 18 months, respectively. This local treatment is the best therapeutic alternative for patients with pulmonary aspergilloma who are not candidates for surgery.

Aminocaproic Acid↗
PubMed1995

[An epidemiological study on the relations of patients with hydatid disease. A high-risk population?].

A serological study was undertaken by means of indirect hemagglutination (IHA) in 57 households of eleven patients with confirmed pulmonary hydatidosis (by serology and surgical procedure). Serum samples from 40 blood donors were used as control group. The IHA positivity rates were 90.8%, 40.3% (23/57) and 2.5% (1/40) in patients with hydatidosis, households of these patients and blood donors (control group). Hydatidosis was confirmed in 4 out of 23 cases of IHA positive households. The high incidence by IHA in households living with patients with hydatid disease can be a good screening parameter to identify a high-risk asymptomatic population carrying the disease at an early phase.

Adolescent↗
PubMed1994

[Primary sternal hemangiosarcoma].

We describe a 22-year-old man with a bone mass in the middle and lower third of the sternum with no signs of respiratory deterioration. After biopsy by incision established a diagnosis of hemangiosarcoma, appropriate resection and repair of the thoracic wall was scheduled. An adequate amount of tissue for analysis must be obtained to allow choice of a surgical technique that will assure the best prognosis in malignant tumors of the sternum and assignation of the most appropriate mechanical ventilation procedure.

Adult↗
PubMed1994

Prognostic factors in pulmonary metastases from colorectal cancer.

Surgery represents the first-choice treatment to manage pulmonary metastases from colorectal cancer when the primary tumor has been controlled and there is no evidence of metastatic spreading to any other organ. In our experience on 13 patients, we obtained a survival at 5 years of 23%. The average number of metastases resected was 2.9. The increase of carcinoembryonic antigen was the first clinical sign in 10 cases (76.9%, higher or equal to 5 ng/ml) that led to its discovery. The surgical technique most frequently used was wedge resection and/or atypical segmentectomy. Intraoperative mortality was zero and morbidity low (15.3%).

Carcinoembryonic Antigen↗
PubMed1994

Thoracotomy in patients over 70 years old.

One hundred cases of patients aged 70 yrs or older, who had undergone surgical intervention for a thoracic pathology between 1981 and 1990, were reviewed. The mean age was 73 yrs, and bronchial cancer the most frequent aetiology (55%). A systematic detailed study before surgery is recommended in the these patients, who have the highest operative risk, and whom we should try to treat most conservatively. Although the rate of complications was higher than the normal average, mortality was only 4%, and was related to the greater or lesser aggression of the surgery. In cases of diagnosed bronchial cancer, a survival of 2 yrs was obtained in 66%, 3 yrs in 50%, and 5 yrs in 26%. We conclude that, theoretically, at the age of 70 yrs or older there is no contraindication for surgery, although it does increase the postoperative morbidity.

Actuarial Analysis↗
PubMed1992

The role of the matrix calcium level in the enhancement of mitochondrial pyruvate carboxylation by glucagon pretreatment.

The effect of Ca2+ on the rate of pyruvate carboxylation was studied in liver mitochondria from control and glucagon-treated rats, prepared under conditions that maintain low Ca2+ levels (1-3 nmol/mg of protein). When the matrix-free [Ca2+] was low (less than 100 nM), the rate of pyruvate carboxylation was not significantly different in mitochondria from control and glucagon-treated rats. Accumulation of 5-8 nmol of Ca2+/mg, which increased the matrix [Ca2+] to 2-5 microM in both preparations, significantly enhanced pyruvate carboxylase flux by 20-30% in the mitochondria from glucagon-treated rats, but had little effect in control preparations. Higher levels of Ca2+ (up to 75 nmol/mg) inhibited pyruvate carboxylation in both preparations, but the difference between the mitochondria from control and glucagon-treated animals was maintained. The enhancement of pyruvate dehydrogenase flux by mitochondrial Ca2+ uptake was also significantly greater in mitochondria from glucagon-treated rats. These differential effects of Ca2+ uptake on enzyme fluxes did not correlate with changes in the mitochondrial ATP/ADP ratio, the pyrophosphate level, or the matrix volume. Arsenite completely prevented 14CO2 incorporation when pyruvate was the only substrate, but caused only partial inhibition when succinate and acetyl carnitine were present as alternative sources of energy and acetyl-CoA. Under these conditions, mitochondria from glucagon-treated rats were less sensitive to arsenite than the control preparations, even at low Ca2+ levels. We conclude that the Ca(2+)-dependent enhancement of pyruvate carboxylation in mitochondria from glucagon-treated rats is a secondary consequence of pyruvate dehydrogenase activation; glucagon treatment is suggested to affect the conditions in the mitochondria that change the sensitivity of the pyruvate dehydrogenase complex to dephosphorylation by the Ca(2+)-sensitive pyruvate dehydrogenase phosphatase.

Adenosine Diphosphate↗
PubMed1992

Gigant carcinosarcoma.

We present a case with gigantic carcinosarcoma (the largest described to date, diameter of 20.5 cm), located in the right upper lobe, in which the discordance between the brief clinical course with limited symptoms and its large size were remarkable. Preoperative diagnosis by bronchial biopsy, as used to be the case in this malignancy, was incorrect (epidermoid), and the define histological characterization was made by thoracotomy. The controversy about pathology, diagnosis and treatment of the carcinosarcoma is discussed.

Biopsy↗
PubMed1992

Toxicity studies with flutrimazole.

Studies with 1-[(2-fluorophenyl)(4-fluorophenyl)phenylmethyl]-1H- imidazole (flutrimazole, CAS 119006-77-8), a new topical imidazole antifungal agent, have been carried out to investigate the acute toxicity of the active substance in mice and rats, as well as the acute ocular and dermal irritation in rabbits, the dermal tolerance after repeated dose (21 days) applications in rabbits, and the sensitising, photoallergic and phototoxic potential in guinea pigs using 1% flutrimazole cream. LD50 values after oral or intraperitoneal administration were greater than or equal to 1000 mg/kg in both mice and rats, which reveal a very low acute toxicity of flutrimazole. No differences were found between the excipient and 1% flutrimazole cream in the acute ocular and dermal irritation studies in rabbits, the irritation indexes being indicative of no lesions due to flutrimazole. Cumulative dermal irritation studies in rabbits showed an improved local tolerance of a skin cream containing 1% flutrimazole as compared to a commercial skin cream containing 1% clotrimazole. The irritation indexes were 1.2 and 3.7, respectively (p less than 0.01). The corresponding histophatological findings confirmed the better local tolerance of 1% flutrimazole cream. Furthermore, it has been found that flutrimazole cream lacks sensitising potential (Magnusson and Kligman test), is also devoid of phototoxic potential and does not induce photoallergic reactions in guinea pigs, these data being confirmed by histopathological studies. These results, together with the very slight systemic absorption rate of flutrimazole from the 1% topical drug form, clearly show that no restrictions should be taken in the use of the cream for reasons of systemic toxicity or dermal tolerance.

Animals↗
PubMed1991

Pulmonary hydatidosis in childhood. Review of 21 cases.

Spain is one of the countries with a very high incidence of hydatidosis in the childhood. It represents 16.8% of all cases intervened for thoracic surgery for hydatidosis cysts in our department during the last ten years with a total of 21 children (inferior to 14 years) operated due to hydatidosis. Cough and pain were the symptoms more frequently encountered. The ratio unruptured/ruptured cysts was 3/1, higher than in the adults, with an average of 2.62 cysts per patient. Specific immunoglobulin E and histamine liberation test were the most useful tests in the laboratory. The usual surgical technique was a cystopericystectomy with total extirpation of the parasite of its rests. No recurrence was found in the follow-up of our patients.

Adolescent↗
PubMed1990

Thoracic surgery in the elderly: review of 100 cases.

One hundred cases surgically intervened due to thoracic pathology between 1977 and 1986 were studied. The ages were equal to or higher than 70 years. Mean age was 73.13 years (70-91). In 70 cases a neoplastic aetiology existed (78.57% of primary bronchial carcinoma), while in the other 30 cases the cause was not neoplastic. In these cases with a high operative risk, a detailed systematic study before surgery is recommended, which should be treated in the most conservative possible way. Although the complication rate was higher than the average in other groups (p less than 0.05), mortality was only 4%, being related, to a greater or lesser extent--, to the surgery (p less than 0.05). In the cases diagnosed as bronchial carcinoma, a 2-year survival was obtained in 66.4%, 3 years in 49.8% and 5 years in 25.7%, concluding that an age equal to, or higher than, 70 years does not represent any contraindication for thoracic surgery.

Age Factors↗
PubMed1990

Bilateral spontaneous pneumothorax associated with metastasis of a malignant fibrohistiocytoma.

The case of a 34-year-old female patient is presented. The patient was admitted because of bilateral pneumothorax caused by the metastasis of a malignant histiocytoma originating in the left gluteus. Bilateral chest-suction was made and the patient received complex chemotherapy. The chest X-ray taken 4 months later showed considerable regression of the lymph node metastases. Neither the time of development of pneumothorax nor its mechanism is known. There are only assumptions about it. Authors have considered their case worthy of publication because the lymph node metastasis of bilateral simultaneous pneumothorax due to histiocytoma has not so far been known in the literature.

Adult↗
PubMed1989

Subglottic inflammatory pseudotumor in a 6-year-old child.

Inflammatory pseudotumors have been given diverse--no fewer than 19--names in the literature. The most frequent localization is in the lung, the gastrointestinal tract, and salivary glands. The case presented here at the subglottic level is exceptional. Although the intraoperative diagnosis is not easy, the prognosis is usually good. Malignant degenerations have not been described. In those cases that cannot be operated on or that extend into the mediastinum, radiotherapy is indicated.

Child↗
PubMed1989

Surgical treatment of thoracic hydatidosis. A review of 100 cases.

Hydatid cystic disease continues to hold an important place in chest disease in our country. The authors review their experience from 1977 to 1987 of 100 patients who underwent surgery for pulmonary hydatidosis. Mean age was 36.21 years. Fifty-nine cases were ruptured cysts (RC) and 41 were unruptured cysts (UC). The diagnosis was based on epidemiological, radiological and mainly serological and endoscopic criteria. The indirect haemagglutination test was positive in 100% of RC and 80% of UC, while 70.2% of the patients who underwent fiberoptic bronchoscopy showed pathological changes. The most commonly used surgical procedure in UC was open subtotal cystopericystectomy (89.09%), while wedge resection (41.81%) was the most commonly used technique for the RC. There were no operative deaths and no recurrences were observed for a mean follow-up of 5.4 years. The indications for adjuvant chemotherapy with mebendazole are presented.

Adult↗