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Biomedical subjects

M Aguilar

Publications and source records attributed to M Aguilar.

At least 91 records · Page 5Linked to original sources
PubMed1990

Giant basilar aneurysm in the course of subacute bacterial endocarditis.

We describe a man aged 42 years with mitral valve regurgitation who suffered from subacute bacterial endocarditis caused by Streptococcus morbillorum. The clinical picture began with a toxic syndrome. Five months later, the patient had an embolic episode and a right rostral pontine stroke, which was followed a few days later by an adversive focal seizure on the right. Despite antibiotic treatment, he suffered complete third nerve palsy. Arteriography, magnetic resonance imaging, and computed tomography of the brain showed a giant aneurysm in the rostral end of the basilar artery; the aneurysm was clipped. We discuss the clinical features, radiology, and characteristics of this aneurysm as a unique case of a giant bacterial aneurysm in the vertebrobasilar system.

Basilar Artery↗
PubMed1990

[Neurological disorders: a primary care approach].

The aim of this study was to evaluate the proportion of neurological disorders within the overall number of ailments treated in primary care, as well as to classify them, determine the reason for their referral to specialists, and analyze the appropriateness or justification of such referral in each case. The 553 neurological visits analyzed represented 6.1% of the total (non-bureaucratic-related) number of requests for medical care. The groups cephalea/facial pain, dizziness and partial or complex seizures accounted for 60% of total. One of every three visits was referred to a neuropsychiatrist and/or hospital service. The main cause for the referral was considered clinical in only 28.3% of cases. The referral was judged inappropriate by the specialist in 13.4% of cases. The evidence that neurological disorders are not unusual, in addition to the high rate of referrals and an analysis of the reason and justification for referral, reflect the need to focus on the neurological training of non-neurologists, as well as to evaluate the appropriateness of present specialized outpatient care.

Age Factors↗
PubMed1989

Left non-dominant hand mirror writing.

A 38-year-old right-handed woman, who had suffered a left cerebral hemisphere infarction, was studied. She developed right hemiparesis, motor and sensory aphasia, and left hand mirror writing. All possible brain mechanisms involved in writing, either perceptual or motor, were investigated in search of the one responsible for her mirror writing; however, no abnormality was detected. On examination of the left handwriting, in the directionality of writing tracings as related to the body midline, we detected a lack of inversion of the right handwriting motor patterns--at the moment they are transmitted from the left to the right cerebral hemisphere--implicating a motor rather than a perceptual mechanism.

Adult↗
PubMed1989

[Diffuse meningeal melanoma].

Diffuse leptomeningeal melanoma is an uncommon condition; its diagnosis is difficult, and requires the detection of atypical melanic cells in the CSF or the performance of meningeal biopsy. We report a 34-year-old patient with progressive symptoms of intracranial hypertension of 2 months duration, in whom meningeal biopsy was required for a definitive diagnosis. The patient's age, the neuropathological abnormalities and the images of computed tomography scan (CT), and also a through clinical and paraclinical investigation, led us to the conclusion that the patient had diffuse primary leptomeningeal melanoma.

Adult↗
PubMed1989

[Tongue paralysis of neoplastic origin].

Tongue paralysis are often underestimated, particularly when isolated or having a chronic course. Sometimes, its early recognition may lead to the diagnosis of a tumor process, favorably modifying its course. We have retrospectively analyzed 13 cases of tongue paralysis of neoplastic etiology. In a woman, the paralysis was due to a lesion of the corticobulbar pathway whereas in the remaining 12, the alteration occurred in the hypoglossal nerve, particularly at extrabulbar intracranial and cranial base tract (10 cases). The clinical picture was due to the primary tumor in 9 patients, and due to bone or leptomeningeal metastases in the remaining four cases. In five cases, the lesion of the XII cranial nerve was essential for the diagnosis of the neoplasm or the neoplastic recurrence and in four cases, it was the only affected cranial nerve.

Adolescent↗
PubMed1988

Effect of captopril at two different dosage regimens in hypertensive non-insulin dependent patients.

Thirty patients (21 F, 9 M) of mean age 55.3 years with non-insulin dependent diabetes mellitus of mean duration 10.8 years and hypertension (blood pressure 160/95 mm Hg) of 0.3 to 4.0 years were randomly allocated to either a twice daily regimen of captopril (50 mg twice daily, Group A) or a once daily captopril schedule (50 mg once daily, Group B). Good glycaemic control (HbA1c, mean 7.63%) had been achieved with sulphonylureas in 22 patients and insulin in 8 patients. There were no statistical differences in baseline values between the two groups. For the 15 patients in Group A, blood pressure fell significantly from a baseline of 177 +/- 13.2/106 +/- 7.8 mm Hg to 161 +/- 14.3/91 +/- 6.9 after one month (P less than 0.05) and continued to decrease at 3 and 6 months. In Group B the blood pressure changed from 179 +/- 19.0/110 +/- 15.6 to 169 +/- 21.0/98 +/- 7.2 at 1 month (P less than 0.05) with further reductions again seen at 3 and 6 months. Nine patients had poorer response than the other 21 but there were no demographic differences between these subgroups nor were there any differences in plasma renin activity or aldosterone responses. There were no statistically significant changes in haematological or biochemical values in either group during treatment. In particular, HbA1c and fasting glucose were unaffected by captopril treatment. No side effects were encountered during the 6 months of follow-up. In conclusion, captopril is an effective antihypertensive in non-insulin dependent diabetes mellitus with mild to moderate hypertension and a once daily regimen could improve compliance.

Captopril↗
PubMed1983

Chronic arsenic poisoning in the north of Mexico.

1 We compared the prevalence of signs and symptoms of chronic arsenic poisoning in two rural populations. 2 The arsenic concentration in the drinking water of the exposed population was 0.41 mg/l, and 0.007 mg/l in the control population. 3 The arsenic was present mainly (70%) in its pentavalent form. 4 The objective was to quantitate health effects and risks derived from chronic ingestion of arsenic in contaminated water. 5 In the exposed population, 21.6% of the sample, showed at least one of the cutaneous signs of chronic arsenic poisoning against 2.2% in the control town. 6 Non-specific symptoms were more prevalent in the exposed population and they occurred more frequently in those individuals with skin signs. 7 The relative risk of suffering a particular manifestation of poisoning, ranged from 1.9 to 36 times higher in the exposed population. 8 We estimated the risks above mentioned, which were derived from exposure to minute quantities of arsenic in a known proportion of its oxidation states during a life time period.

Adolescent↗
PubMed1982

Prostatic melanosis with involvement of benign and malignant epithelium.

We report an unusual case of prostatic melanosis. Grossly, the majority of prostatic chips contained areas of black discoloration. Microscopically, pigment was identified within the prostatic stroma, in benign prostatic ducts and within the cells of a well differentiated prostatic adenocarcinoma. The pigment was identified as melanin by histochemical methods and electron microscopy. The histogenesis of prostatic melanosis is discussed and it is proposed that the melanin pigment is derived from (aberrant) stromal melanocytes.

Adenocarcinoma↗
PubMed1980

[Pellagroid encephalopathy in chronic alcoholism. Clinicopathological study (author's transl)].

Pathological findings from two patients with clinical symptoms of diffuse encephalopathy who died due to a bronchopneumonia are studied. Postmortem examination of the central nervous system revealed neuronal changes which suggested the diagnosis of pellagroid encephalopathy. The differential diagnosis between several diseases characterized by encephalopathy, alcohol ingestion and malnutrition are discussed (chronic alcoholism, acquired hepatocerebral degeneration, Marchiafava-Bignami's syndrome, Morel's lamilar sclerosis, Wernicke-Korsakoff's syndrome and pellagroid encephalopathy). Alcoholic encephalopathy should be considered a medical emergency, which requires early correction of the basal parameters and prompt administration of thiamin and nicotinamide-nicotinic acid in doses of 500 mg per day i.v. followed by 200-300 mg per day of niacinamide by mouth.

Adult↗
PubMed1980

[Benign congenital myopathy with type I fiber predominance and rare "cores" in the asymptomatic mother. Association with malformations of the midline (author's transl)].

The case of a 20 year-old female with a congenital myopathy and multiple midline malformations (cranio-facial dysplasia with cleft-palate, cervical and dorsal vertebral blocks and sacro-lumbar spina bifida) is reported. A muscle biopsy showed only a predominance of type I fibres (97,3 p. 100). A muscle biopsy from the asymptomatic mother showed a predominance of type I fibres (95 p. 100) and a small number of fibres (less than 5 p. 100) with central or peripheral cores. Other fibres showed subsarcolemnic mitochondrial aggregates and slight architectural alterations. These findings confirm the variable histological patterns in benign congenital myopathies and emphasize the usefulness of studying the asymptomatic parents of such patients in whom a predominance of type I fibres is the only change present in the muscle biopsy.

Abnormalities, Multiple↗