Search PubMed⌕ Search

Biomedical subjects

M Romero

Publications and source records attributed to M Romero.

At least 199 records · Page 11Linked to original sources
PubMedDate not supplied

Percutaneous interventions on severe coarctation of the aorta: a 21-year experience.

Different percutaneous interventions can be used to treat coarctation of the aorta. However, a great amount of information is still needed regarding the long-term course. This article reviews our experience spanning 21 years in the percutaneous treatment of aortic coarctation. Four different conditions for treatment were considered. The first condition 1 (group 1) was balloon angioplasty in neonates and infants with untractable heart failure (n = 54; mean age, 1.2 +/- 1.4 months). After balloon angioplasty, most infants sustained significant clinical improvement. However, 9 patients died in the hospital (17%). As a result, we monitored the course of the 45 survivors during a mean period of 10 +/- 6 years (range, 1-19). During this follow-up period, 17 patients needed a single additional intervention on coarctation (8 underwent surgery and 9 were treated percutaneously). After this second treatment, 11 patients needed one or more further interventions. The actuarial survival probability was 83% at 19 years, with 43% of patients remaining surgery free and 23% reintervention free. The second condition (group 2) was balloon angioplasty in children and adults with coarctation of the aorta before the stenting era (n = 28; mean age, 13 +/- 8 years). After treatment, serial hemodynamic and angiographic studies were performed. The long-term relief was higher in patients with a discrete type of coarctation. The rate of late aneurysm formation was 6%. The third condition (group 3) was stent palliation in infants and children younger than the age of 6 years (n = 17; mean age, 2.1 +/- 1.7 years). The stent was implanted for nondilatable stenoses, as a nondefinitive procedure. Stent palliation provides complete initial relief in hypoplastic coarctations or life-threatening conditions. However, further stent expansion is required to ensure adequate stent diameter in the growing aortic wall. In addition, late intrastent proliferation may occur in small stent diameters (18%) and aneurysm formation in hypoplastic coarctations (18%). Both late complications can be managed percutaneously. The fourth condition (group 4) was stent repair of severe aortic coarctation in adults, adolescents, and children older than the age of 6 years (n = 73; mean age, 20 +/- 12 years). Significant relief was observed after treatment, which persisted at follow-up. One patient died at treatment (1.3%). After a mean follow-up of 5 +/- 3 years, all 72 patients remained symptom free and no restenosis or late aneurysm were detected.

Adolescent↗
PubMedDate not supplied

[Melanoma metastasis to the gallbladder].

Metastasis to the gallbladder is rare. Malignant melanoma is the tumor that most often metastasizes to this site. For this reason, the finding of solid lesions in the gallbladder wall in patients with advanced stage melanoma should lead to the suspicion of metastatic disease. The aim of this report is to describe and illustrate a case of surgically confirmed malignant melanoma metastasis to the gallbladder and to review the most significant ultrasound findings described in the literature for gallbladder lesions caused by melanoma.

Gallbladder Neoplasms↗
PubMedDate not supplied

[The consistent use of condoms among intravenous drug users and their regular partners].

OBJECTIVE: To describe consistent condom use between drug injectors and their regular sexual partners and to identify factors associated to its use which may be amenable to intervention. METHODS: Information was collected by personal interviews of drug injectors in 13 sampling points of the city of Granada, Spain. A bivariate analysis of factors identified in the literature was carried out and a multivariate logistic regression was fitted to the data to test the hypothesized associations. RESULTS: The proportion of drug injectors who report consistent condom use with their regular partners was 26. 4%. Talking about condoms with other injectors and with their regular sexual partners, professional sources of information and counselling when receiving results of HIV testing are independently associated with the use of condoms. In terms of social indicators, those with the highest and lowest levels of social integration use condoms less than those who belong to the middle social group. Sociodemographic characteristics and history of drug injection are not associated with consistent condom use with the regular partner. CONCLUSION: The use of condoms between drug injectors and their regular sexual partners is associated with communication with other drug injectors, the sexual partner and hearth professionals, on this topic. Promoting consistent condom use with regular partners among intravenous drug users is best accomplished through peer groups and during HIV counseling.

Adult↗
PubMedDate not supplied

Increased apoptosis in acute puromycin aminonucleoside nephrosis.

Acute puromycin aminonucleoside nephrosis (PAN) in rats is characterized by heavy proteinuria associated with renal hypercellularity. The role of apoptosis in the resolution of renal hypercellularity was investigated in PAN. To study the participation of apoptosis in PAN, renal tissues were collected from nephrotic and control rats on weeks 1, 2 and 7 after a single puromycin aminonucleoside injection. Apoptosis was evaluated by light and electron microscopy. Apoptotic DNA fragmentation was detected by TUNEL staining. Renal tissues were also evaluated by the presence of leukocyte common antigen (LCA), ED1 (macrophages) and proliferating cell nuclear antigen (PCNA) with corresponding monoclonal antibodies. An increased number of apoptotic (TUNEL+) cells was observed in the glomerulus at week 1. Electron microscopy analysis showed glomerular apoptosis mainly in endothelial cells. In the interstitium and tubules, increased apoptosis was observed at weeks 1 and 2. Increased apoptosis was accompanied with increased LCA+, ED1+ and PCNA+ cells in the interstitium and with increased PCNA+ cells in tubules. There was a high significant correlation between the number of apoptotic cells and the number of interstitial LCA+, ED1+ and PCNA+ cells. Tubular PCNA expression was correlated with tubular apoptosis. We also observed significant correlation between glomerular, interstitial and tubular apoptosis with proteinuria during the nephrosis. Double staining analysis showed that about 13% of interstitial or tubular apoptotic cells were positive for PCNA. All these values returned to normal by week 7. These results indicate that apoptosis is involved in the repairing process of this disease model.

Acute Disease↗
PubMedDate not supplied

Characteristics of Mexican women admitted to emergency care units. Alcohol consumption and related problems.

OBJECTIVE: This article describes the demographic characteristics and psychological differences in a sample of female heavy and non-heavy drinkers who attended three emergency services of the Mexican city of Pachuca, Hidalgo. MATERIAL AND METHODS: A sample of patients seen at emergency services (ES) patients over the age of 18 was selected using ES admission forms. Twenty-five-minute, face-to-face interviews were conducted by a group of trained interviewers. Patients answered various questionnaires and scales to measure alcohol consumption and to provide information on variables that have proved to be related to female drinking. RESULTS: Thirty-six women (5.2%) out of 717 of the total number of women were found to be heavy drinkers according to the TWEAK scale. This group of women had 2.3 times the risk of becoming depressed, 2.87 times the risk of taking other drugs, 1.95 times the likelihood of having been sexually abused and 1.57 times the risk of displaying suicidal ideation. CONCLUSIONS: Data from this small analysis confirm international findings that problem drinking among females throughout the life cycle is linked to depression. As regards the screening instruments employed, it is necessary to conduct more in-depth research to enrich their contents and increase their reliability and validity when used among female populations. In this study, the TWEAK proved to be extremely useful for studies in emergency services.

Adolescent↗
PubMedDate not supplied

Prevention issues in a multicultural developing country: the Mexican case.

This paper reviews some cultural issues in Mexican society related to alcohol/drug use and misuse. The aim is to provide information that could aid in the identification of opportunities and barriers for preventive actions appropriate to this country. Some of the country's sociodemographic characteristics and a historical overview of alcohol/drug use and misuse are presented, as are also data obtained through different research strategies such as anthropological studies and epidemiological surveys among different populations. An overview of the current preventive interventions and some suggestions to improve conceptualization on alcohol/drug use and misuse for future research and to guide preventive actions are included.

Adolescent↗
PubMedDate not supplied

[Alcoholic beverage consumption in the patients of the emergency services of the city of Pachuca, Hidalgo].

OBJECTIVE: Prevalence of alcohol consumption and abuse among patients with medical emergencies, accidents and violence, attending an emergency room in one of three public health hospitals in Pachuca, Hidalgo, was studied. MATERIAL AND METHODS: Patients answered a questionnaire and their blood alcohol was measured on their first visit to the emergency room. The questionnaire gathered socio-demographic data, patterns of alcohol consumption and included scales for heavy and dependent drinkers, such as the CAGE and the alcohol use disorders identification test (AUDIT). Injured and non-injured patients were compared with the chi 2 statistics. RESULTS: A total of 1,511 patients were evaluated. Alcohol consumption was higher in those attending for accidents or violence than in medical patients. Positive blood alcohol levels were found in 17.7% of injured patients and 15.8% reported alcohol consumption 6 hours prior to the accident. According to the CAGE, 9.2% of the patients were alcohol-dependent, and 10.9% were heavy drinkers according to the AUDIT. CONCLUSIONS: Alcohol consumption, especially among emergency room patients attending for accidents or injuries is high. Preventive measures are indispensable to diminish social and individual costs of alcohol abuse in this population.

Adolescent↗
PubMedDate not supplied

Human herpesviruses HHV-4 (EBV) and HHV-6 in Hodgkin's and Kikuchi's diseases and their relation to proliferation and apoptosis.

BACKGROUND: Human herpesviruses types 4 and 6 (EBV, HHV-6) are frequently found in Hodgkin 's disease (HD) and--to a certain extent--in Kikuchi-Fujimoto's disease (KFD). Both viruses are apparently related to proliferative and/or apoptotic processes as represented by HD or KFD respectively. OBJECTIVE: To correlate frequency and location of antigen- and DNA expression of both viruses in HD and KFD tissue sections in relation to markers for cell proliferation and apoptosis. STUDY DESIGN: Archival lymph node biopsies from 103 patients with HD and 14 KFD patients were investigated immunohistologically for viral antigen expression (EBV LMP- 1: HHV-6 pl 10/60), Ki67/PCNR, marker for proliferation (MIB1)/p53 and WAF1 for apoptosis. Viral DNA was shown by in situ hybridization. Apoptosis was determined by ISEL and TUNEL techniques. RESULTS: HD is frequently infected by both EBV and HHV-6 while KFD tends to be infected only by HHV-6. EBV in HD is present in HD cells and in Reed-Sternberg cells (HD/RS cells), HHV-6 preferentially in lymphocytes and in histiocytes in both HD and in KFD. Proliferation marker Ki67 is found in lymphocytes and histiocytes of both diseases and in HD and RS cells in HD. Apoptosis is demonstrated in lymphocytes and histiocytes preferentially in KFD and to a lesser extent also in HD. CONCLUSION: Although EBVand HHV-6 may not be openly oncogenic in HD and KFD, they may well influence the course of the disease. Dual infection in HD appears to support proliferative processes, i.e. a predominance of EBV effects. Single infection with HHV-6 in KFD instead appears to favor an apoptotic course. These effects are--according to the literature--possibly cytokine-mediated.

Adolescent↗