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Biomedical subjects

M Ortega

Publications and source records attributed to M Ortega.

122 records · Page 7Linked to original sources
PubMedDate not supplied

[Comparative study of the different radiotracer administration route to locate the sentinel node in breast cancer].

AIM: To assess the results of Sentinel Lymph Node (SLN) detection in breast cancer patients depending on the radiotracer injection route, especially evaluating which route that makes it possible to identify the highest percentage of SLNs and its detection in the inner mammary chain. METHODS: We prospectively studied 120 breast cancer patients. Three groups of 40 patients each were established depending on the radiotracer injection route. 1) Subdermal or subareolar route: 18 T1 and 22 T2, mean tumor diameter size of 1.76 cm. 2) Peritumoral route: 16 T1 and 24 T2, mean tumor diameter size of 1.86 cm. 3) Intratumoral route: 20 T1 and 20 T2, mean tumor diameter size of 1.61 cm. The day before surgery, a lymphoscintigraphic study was performed in all cases and intraoperative SLN resection was carried out with the aid of a hand-held gamma probe. RESULTS: The SLN was identified in 38/40 cases (95%) of group 1, in 35/40 cases (88%) of group 2 and in 38/40 cases (95%) of group 3. No SLNs in the mammary chain were observed in patients who underwent subdermal/subareolar injection of the radiotracer. On the other hand, SLNs were visualized in this location in 4/35 patients with peritumoral injection (11%) and in 8/38 patients with intratumoral injection (21%). CONCLUSION: The superficial (subdermal, subareolar) injection technique is more suitable when an unnecessary lymphadenectomy has to be prevented in cases without axillary metastases. The deeper injection technique (peritumoral, intratumoral) should be use when, moreover, we seek accurate staging or plan non-systematic mammary chain irradiation.

Adult↗
PubMedDate not supplied

[Usefulness of the sentinel node in the treatment and staging of initial cervix cancer].

OBJECTIVE: The aim of this study was to evaluate the usefulness of intraoperative sentinel node (SN) detection in patients with initial cervix cancer. PATIENTS AND METHODS: Lymphoscintigraphy and intraoperative SN detection was performed in 17 patients with initial cervix cancer who we going to have a radical laparoscopic hysterectomy and pelvic lymphadenectomy. Conization was performed in 4/17. The day before surgery, an injection of 111 MBq 99mtechnetium nanocolloid around the primary tumour and a subsequent lymphoscintigraphy were carried out. Blue dye was injected at the same location intraoperatively. A laparoscopic gamma probe was used to identify SNs. RESULTS: SNs were successfully localized using a combination of radiocolloid and blue dye in 16/17 patients (detection rate 94 %). The detection rate only using blue dye technique decreases to 71 % (12/17) and it reaches an 82 % (14/17) if we avoid the blue dye injection. In 3 cases, there was no migration in lymphoscintigraphy and in one of the three SN could not be detected. Thirty-three SNs were identified (1.9 nodes/patient). The most frequent location was left external iliac nodal group (13 nodes: 39 %). SNs were identified in regions that are not included in usual lymphadenectomy: right parametrium (2 sentinel nodes, one of them in the retrouterine region), and interiliac (2 SNs). In all four patients with previous conization SNs were identified (detection rate 100 %). CONCLUSIONS: The rate of SN detection combining lymphoscintigraphy with gamma probe and blue dye is 82 %. The use of blue dye allows increasing this rate to 94 % in those cases which migration was not seen or when the SN is placed near the injection site. The SN technique offers the possibility to find SNs in regions not included in usual lymphadenectomy.

Adult↗
PubMedDate not supplied

[Psoas abscess as cause of lumbar spine pain detected by scintigraphy with gallium in a patient with suspicion of spondylodiscitis].

A 56 year old man with fever and lumbar pain who underwent an abdominal CT scan that showed lumbar arthrosic changes, although it was not possible to rule out infectious disease in L5/S1. Bone scintigraphy was requested. It showed heterogeneous hyperuptake that did not make it possible to exclude a spondylodiscitis in this site. Scintigraphy with 67Ga-citrate excluded infectious diseases in the lumbar spine column. However, a pathological uptake was observed in the left iliac fossa suggestive of psoas abscess, which was confirmed by ultrasonography, isolating streptococcus viridans.

Citrates↗
PubMedDate not supplied

[Patient satisfaction survey in emergency departments in acute care hospitals].

OBJECTIVE: To describe patient satisfaction with emergency care of different hospitals. METHODS: patients attended in emergency departments of nine acute hospitals. A patient satisfaction questionnaire was used which includes relevant areas for patients and emergency departments workers 1,940 patients were selected to be surveyed by phone, by previously trained interviewers. RESULTS: 1, 423 patients were interviewed. They reported that mean waiting time until were seeing by the physician ranged from 20 to 60 minutes and total time at the emergency room from 60 to 170 minutes. Interviewees negative ratings for both were of 38% and 36% respectively. Information given about the problem of the patient was negatively rated by 6 to 17%, and about the treatment to follow by 8 to 16% of them. 5% referred not getting information on the latest. Up to 30% of patients said not were clearly informed of the results of the test performed Interpersonal care was positively rated in 55% of cases in some hospitals. Global evaluation gave positive ratings of 58% and negatives of 14%. CONCLUSIONS: This survey detect significant differences among all the centers in the study. Waiting time area showed the greater differences among them. Also the worst qualifications, followed by information to patient. Patient satisfaction questionnaires may work as aid in detecting health care problems.

Adult↗
PubMedDate not supplied

Inventory of potential reconstructive needs in the patient with burns.

The rehabilitation and reconstruction of patients who survive large burns is an arduous task. To facilitate it we have devised an inventory form to accurately record the somatic abnormalities caused by burns and also the severity and location of burns. This form was used in the assessment of 25 pediatric patients with massive burns. It was found to be a very useful tool that allowed the identification of more specific functional and esthetic deformities than is possible with currently available forms. It also served as a template for the systematic planning of reconstructive procedures.

Burns↗
PubMedDate not supplied

Multichannel cochlear implant in a deaf-blind patient.

In this work, a case study of the first deaf-blind patient implanted with the Combi-40 cochlear implant is analyzed. The patient is a 69-year-old man who has been blind since the age of 25 and deaf since the age of 51. Before surgery, his wife used Braille and finger-spelling on his hand to communicate with him. In this study, we intend to show how the rehabilitation program was applied to his particular characteristics and to describe the problems we faced throughout the process. Significant improvements in the dynamic ranges of perception and comprehension of segmental features of speech were observed within two weeks after the setting up. Within four weeks, the patient was able to maintain a simple conversation through the cochlear implant alone, and he abandoned the use of tactile communication. Nowadays, he is able to speak over the phone. A battery of tests was performed 2, 4 and 6 months after the switch-on. The results obtained for this patient, whose scores are among the best in our experience, suggest that deaf-blind individuals may benefit from a multichannel cochlear implant as an auditory substitute.

Blindness↗
PubMedDate not supplied

[Usefulness of the blink reflex in a case of brainstem neuro-Behcet's disease].

INTRODUCTION: Brainstem is the most frequently affected structure in neurobehçet disease. Brainstem auditory evoked responses (BAER) and magnetic resonance imaging (MRI) have been employed in early diagnosis of the disease. We present here a case of neurobehçet disease which brainstem lesion was suspected by blink reflex and corroborated by MRI. BAER were normal in this case. CLINICAL CASE: The patient was a woman, 49 years old, diagnosed from Behçet's disease. Clinical symptoms consisted of dizziness, headache, nausea, vomiting and bilateral tinnitus preceded by fever in the previous days. Neurological examination showed increased tendon reflexes and adiadochokinesis. Cerebrospinal fluid was inflammatory but aseptic. Computerised tomography and BAER were normal. Blink reflex recording showed abnormalities after the stimulation of the right supraorbital nerve in R2 component, ipsilateral and contralateral, the remainder components being normal. This finding was compatible with a lesion in the spinal tract-nucleus of the right trigeminal nerve. Cranial MRI showed several areas of high signal intensity in protuberancial calotte and spinal tract-nucleus of the trigeminal nerve. The patient improved after prednisone and chlorambucil combined therapy. Serial blink reflex studies were normal, while the patient was asymptomatic. CONCLUSION: These results indicate that determination of blink reflex together with BAER may be of help in the evaluation of a more extensive area of the brainstem in neurobehçet's disease, even in absence of trigemino-facial symptomatology. Early diagnosis is important because of neurobehçet's morbi-mortality.

Behcet Syndrome↗
PubMedDate not supplied

[Entomology of onchocercosis in Soconusco, Chiapas. 6. Quantitative studies of the transmission of Onchocerca volvulus by 3 species of Simuliidae in a community with high endemicity].

In Guatemala, there is no doubt about the participation of Simulium ochraceum as vector of Onchocerciasis. However, in Mexico practically there are not studies focussed to determine the role of this species in the transmission. The objective of the present investigation was to determine which of the 3 species of Simulium founded in the Soconusco region of Chiapas, is the main, and which were secondary in the transmission of Onchocerciasis in that area. The locality of Morelos, in the Huixtla "municipio" of Chiapas, localized a 1200 meters over the sea level (mosl) were selected to carried out the present study. According to own parasitological studies, this locality is considered as highly endemic (more than 66% prevalence). From March 1979 to March, 1981, we performed captures of Simulium sp caught on human bait. Quantitative studies and of transmission potentials were also performed. The following results were obtained: a) Absolute black flies densities (nulliparous and pariparous) and infected black flies (with L1 and L2 larvae): S. ochraceum, S. metallicum and S. callidum, in that order was the distribution of densities. Infected black flies were obtained in the 3 species. However, in despite of an irregular distribution in all the year, it was possible to identify 2 peaks of maximum infection of S. ochraceum in March, 1979 and March 1981. b) Monthly bite densities and infective bites.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗