Biomedical subjects
M Ribera Pibernat
Publications and source records attributed to M Ribera Pibernat.
[Cholesterol embolism disease: study of 16 cases].
BACKGROUND: The cholesterol embolism syndrome is a multisystemic disease resulting from cholesterol crystal embolization to many organs including skin, kidney and CNS. Vascular procedures and anticoagulation have been identified as triggering factors. PATIENTS AND METHODS: Sixteen patients were prospectively reviewed diagnosed of cholesterol embolism syndrome from 1991 to 1998. RESULTS: The mean age was 68 years and all had at least two risk factors for atherosclerosis (hypertension, smoking, diabetes mellitus, hyperlipemia) as well as pre-existing symptomatic atherosclerotic disease. At least one precipitating factor was identified in 14 patients (heparin in 7, coumarins in 4 and vascular procedure in 7). In six patients two or more triggering factors coexisted. Clinically, 12 patients had livedo reticularis, 10 purpuric lesions, 12 purple toes and 4 painful ulcerations. As a result of progressive gangrene 4 patients required amputation of a portion of the lower extremity. The skin biopsy was diagnostic of cholesterol embolism syndrome in 10 cases and was highly suggestive in the remaining cases. Eleven patients developed renal failure but only five required subsequent dialysis. A cerebrovascular accident was reported in two patients and gastrointestinal bleeding occurred in another three patients. Four patients died but only two as a direct result of the disease. CONCLUSIONS: The diagnosis of cholesterol embolisms should be considered among elderly patients, with underlying atherosclerotic disease, who develop typical cutaneous manifestations, hypertension, and renal failure in association with precipitating factors. Given the serious implications of this syndrome, a heightened awareness and preventive measures in the population at risk are essential.
[Classical Kaposi sarcoma of aggressive course].
The aggressive variant of the classical Kaposi sarcoma (KS), though uncommon, has an utmost relevance because its evolutive characteristics entail a great morbidity and mortality. Three classical KS cases are reported which manifested an unusually aggressive course, with extensive cutaneous and visceral involvement. One of the patients was diagnosed of a non-Hodgkin lymphoma 12 months later. None of the three patients responded to the different therapeutic regimens used: polychemotherapy, monochemotherapy and interferon-alfa, respectively. The three patients died within two years after diagnosis. In KS patients with pulmonary involvement, working in coal mines was recorded as occupational antecedent. These three cases illustrate the different clinical and therapeutic characteristics of an uncommon subtype in the KS spectrum in general and of its classical variant in particular. Likewise, the possible role of occupational exposure in the etiopathogenesis of KS is discussed.
[Rheumatoid nodules in patients without definite synovial damage. Review of the subject in relation to 3 cases].
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[Seborrheic dermatitis in HTLV-III/LAV infection].
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[Cutaneo-lymphatic sporotrichosis].
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[Some comments about Sweet's syndrome].
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[Dermatitis caused by mexiletine].
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[Osteolytic lesions in the cranium as a manifestation of secondary syphilis].
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