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P M Moreno

Publications and source records attributed to P M Moreno.

8 recordsLinked to original sources
PubMed2001

Use of contrast echocardiography in the diagnosis of subacute myocardial rupture after myocardial infarction.

Myocardial rupture is an uncommon and catastrophic complication after acute myocardial infarction. It can present in an acute form or in a subacute form, with slower hemorrhage and thrombus formation at the site of rupture. These patients can survive several hours or days before the diagnosis is confirmed and the myocardial ruptured repaired. Two-dimensional Doppler echocardiography is very useful in the diagnosis of this complication, but the number of false-positive diagnoses is high, even in the presence of a large amount of pericardial effusion. In these patients, administration of a contrast agent can be useful to demonstrate active bleeding into the pericardium. We report a case of subacute myocardial rupture for which contrast echocardiography was useful in demonstrating the presence of persistent hemorrhage into the pericardium. To reduce the number of false-positive diagnoses, contrast echocardiography should be considered in patients with possible subacute myocardial rupture.

Aged↗
PubMed2000

Effectiveness of a structured questionnaire for diagnosis of Menière's disease in the first visit.

A structured questionnaire of vertigo (SQV) was used to search patients with Menière's disease (MD) in the first visit. One-hundred consecutive outpatients that complained of dizziness or vertigo were studied. Diagnosis of MD was accepted if three investigators independently recorded it among a list of 29 diagnostic categories after reviewing the SQV. The AAO criteria for definite MD defined by the Committee on Hearing and Equilibrium after 10 months or more of follow-up were the gold standard to contrast questionnaire-based diagnosis. Seven patients were considered as MD with the SQV. The sensitivity (Sn), specificity (Sp) and positive predictive value of the SQV for definite MD were 80%, 97% and 57% respectively, being the false positive rate 3%. The probability for diagnosis of definite MD using the SQV in the first visit was 58% in a set up with a 5% of prevalence. The best predictor selected by all investigators was the presence of hearing loss (Sn 100%, Sp 85%, positive likelihood ratio 6.67). Because of the high specificity, the SQV of vertigo results a useful test to advance the diagnosis of definite MD.

Adult↗
PubMed1998

Solitary neurofibroma of the inferior nasal turbinate.

We present a case of neurofibroma of the nasal inferior turbinate operated under endoscopic control. A 29 year-old female reported progressive left-side nasal obstruction over the past year. Endoscopic examination revealed a mass arising from the left inferior turbinate. Evaluation of multiple sections of the mass by hematoxylin and eosin, S-100 protein and neuron specific enolasa stains showed the tumor to be a neurofibroma.

Adult↗
PubMed1994

Relationship between immune complex and total hemolytic complement in endolymphatic hydrops.

Recently there has been considerable investigation into the relationship of the immune system and immune disorder to Meniere's disease. Immunoglobulin G (IgG) antibody and complement are both present in endolymphatic fluid and it is possible that endolymphatic hydrops is due to immune complex. The authors' results show that patients with endolymphatic hydrops had elevated levels of circulating immune complex (CIC) of IgG (24.80 micrograms/mL). The levels of functional complement activity (CH50) were significantly lower in patients (249.7 HU) than in controls. Circulating levels of CIC and CH50 were positively correlated. Immunoglobulin G, immunoglobulin M (IgM), and subpopulation of B lymphocytes were elevated, but there was no alteration in subpopulations of T-helper, T-suppressor, and natural killer (NK) cells in peripheral blood.

Adult↗
PubMed1992

Changes in immunologic response in tonsillectomized children. I. Immunosuppression in recurrent tonsillitis.

The possible immunoregulatory role of the tonsils was studied by determining immunoglobulins IgG, A, M, E and factors C'3, C'4 and PFB of the complement system before and after tonsillectomy. The synthesis in vitro of IgG and IgM by lymphocytes stimulated with pokeweed mitogen was also measured. There were statistically significant differences between pre and post-operative levels of serum IgG, IgA and IgM, which decreased after surgery. Practically no change in the mean values of IgE and no significant differences in the levels of serum C'3, C'4, and PFB, were found. The in-vitro synthesis of both immunoglobulins (IgG, IgM) by lymphocytes increased significantly after tonsillectomy. Our results suggest that not only does tonsillectomy have no counterproductive effect on the immune system, but that, on the contrary, it seems to improve the immune response, since it appears to unblock the suppression to which the immune system was subject.

Child↗
PubMed1992

Changes in immunological response in tonsillectomized children. II. Decreased cellular response.

The immunological cellular response was studied in 22 children aged between 5 and 10 years. One week before and one month after tonsillectomy, the mitogenic response to phytohaemagglutinin (PHA), concanavalin (ConA) and pokeweed mitogen (PWM) was tested. Our results showed statistically significant decreases in stimulation index (SI) to PHA, ConA and PWM after tonsillectomy. This suggests that the tonsils may influence the cellular immune status in children. The higher level of preoperative activity in children with recurrent tonsillitis could be understood as the result of stimulation of lymphocytes by bacteria.

Child↗
PubMedDate not supplied

[Diagnosis of common causes of vertigo using a structured clinical history].

The structured clinical history is the most sensitive test for diagnosing vertigo. Its diagnostic effectiveness on the first visit was analyzed and key signs and symptoms with high predictive value for common causes of vertigo were identified. One hundred outpatients who complained of dizziness or loss of balance were evaluated using a structured clinical interview. Each questionnaire was examined independently by three blinded investigators, who assigned a diagnosis and identified the elements of the history that figured most prominently in the diagnosis. The gold standard was defined as independent selection of the same diagnostic category by all three investigators. A first-visit diagnosis was obtained in 40% of patients (95% confidence interval 30-50%): 38% women and 42% men. Causes included benign positional paroxysmal vertigo (BPPV, 13 patients), headache-associated vertigo (9), Meniere disease (7), cervical vertigo (3), psychiatric dizziness (2), post-traumatic vertigo (2), vertebro-basilar transient ischemic attack (1), vestibular neuritis (1), convulsive seizure (1), and presyncope (1). The best predictors of BPPV were the precipitating mechanism (specificity [SP] 100%), positional nystagmus (sensitivity [SE] 90%, SP 63%), and the Dix-Hallpike test (SE 82%, SP 71%). Elements predictive of headache-associated vertigo were duration of the attack (minutes) and a personal history of headache (both, SP 100%). Other predictors were facial hypoesthesia (SE 92%, SP 47%) and associated neurological disease (SE 82%, SP 58%).

Adult↗