[Investigation of environmental fungi in the city of Cali].
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Air Microbiology↗
Biomedical subjects
R Alvarez
Publications and source records attributed to R Alvarez.
[Clinical-encephalographic evaluation of new anticonvulsant drugs with "double blind" technic].
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Adolescent↗
Haematogenous Serratia marcescens endophthalmitis in an HIV-infected intravenous drug addict.
A case of haematogenous Serratia marcescens endophthalmitis in an HIV-infected intravenous drug addict is described. The patient was admitted with fever, ocular pain and visual loss in the right eye following an i.v. injection of pulverized buprenorphine. A vitreous humor culture grew S. marcescens. The patient was treated with i.v. ceftriaxone (2 g b. i. d.), i.v. amikacin (500 mg b. i. d.) and p. o. fosfomycin (1 g q. i. d.) for three weeks. The ocular infection was cured, although the visual function was lost, leading to blindness. To our knowledge, this is the second case in the reviewed Anglo Saxon literature of S. marcescens endophthalmitis in parenteral drug addicts.
Adult↗
Lack of association between polymorphisms of the coagulation factor VII and myocardial infarction in middle-aged Spanish men.
In order to determine the role of two polymorphisms in the factor VII gene (R353Q and intron 7 hypervariable region) in the susceptibility to develop early myocardial infarction, a total of 175 patients with acute myocardial infarction aged 50 years or less (mean age 41+/-7 years) and 200 controls (average age 42+/-6) without cardiovascular disease were genotyped for these polymorphisms. Gene and genotype frequencies did not differ between patients and controls. Although the 353-QQ genotype was at a higher frequency among controls (4%) compared to patients (1%), the difference did not reach statistical significance. Carriers of the H7-allele (intron 7 polymorphism) were at a slightly higher frequency among patients (51 vs. 43%; P=0.19; OR=1.36; 95% CI=1.09-1.70). Our data suggest a lack of association between both polymorphisms in the factor VII gene and early myocardial infarction in our population.
Adult↗
[Bone mineral density in children with osteogenesis imperfecta].
OBJECT: Osteogenesis imperfecta is the term used for a group of disorders of collagen synthesis which cause increased bone fragility. The aim of our study was to evaluate the BMD in patients with OI. MATERIAL AND METHODS: We used dual-energy x ray absorptiometry, Hologic QDR 4500W (DEXA), to compare the bone mineral density (BMD) of 8 patients aged from 3 years to 20 years who had osteogenesis imperfecta with an age and sex matched control group. RESULTS: DEXA detected highly significant differences in BMD respecting control group. The mean BMD in the patients with osteogenesis imperfecta was 62.6 % of normal in lumbar spine (p < 0.01) and 63.01 % of normal in the femoral neck (p < 0.01) using Wilcoxon test. CONCLUSION: DEXA is an objective, reproductible and sensitive method of measurement of BMD in children. It may help to stablish the diagnosis, to asses prognosis and possibly to monitor the response to different types of treatment.
Absorptiometry, Photon↗
Immunocytochemical localization of calretinin in the olfactory system of the adult lamprey, Lampetra fluviatilis.
The distribution of calretinin immunoreactive (CR-ir) structures in the adult lamprey (Lampetra fluviatilis) olfactory system was studied by using immunocytochemical techniques. In the olfactory epithelium, a subpopulation of olfactory receptor cells was CR-ir. In the olfactory bulbs, three different cell populations were observed. Large CR-ir cells (mitral cells) were located medially to the olfactory glomeruli and occasionally between them. In the inner cellular layer, two types of CR-ir perikarya were found: numerous small CR-ir cells (granule cells) and some medium-sized CR-ir cells (putative displaced periglomerular cells). In addition, different intensities of CR-ir fibers were present in particular rootlets of the olfactory nerves, as well as in particular glomeruli. The presence of CR-ir cells and fibers in all layers of the lamprey olfactory bulbs supports the idea that this protein is present in pathways underlying the processing of sensory information throughout evolution.
Animals↗
Bilateral tarsal tunnel syndrome caused by varicosities.
The authors present a case report of bilateral tarsal tunnel syndrome occurring in a 39-year-old, slightly overweight female with a long history of varicose veins of her legs. Symptomatology suggestive of tarsal tunnel syndrome was present over the left heel. Vein stripping was done on both legs. When the burning discomfort at the inner aspect of the left heel continued in spite of the strippings, she presented at our Foot Clinic. Surgery on the left heel revealed varicosities overlying the medial and lateral plantar nerves near their origin, and removal of these resulted in prompt relief of her complaints. Nine months later and 10 months following the venous stripping of her right leg, medial right heel pain, burning, paresthesias, and a positive Tinel sign appeared over the inner aspect of her right heel. There was prompt subsidence of these complaints when again varicosities were found and removed.
Adult↗
The simple bunion: anatomy at the metatarsophalangeal joint of the great toe.
The pathomechanics for the development of the hallux valgus deformity takes place at the first metatarsophalangeal joint--the sesamoid complex. The sesamoid complex consists of seven muscles, eight ligaments, and two sesamoid bones. When the first metatarsal escapes the complex and drifts medially, the sesamoids remain twisted in situ, several of the ligaments "fail," and others contract. The authors propose reduction of the metatarsus primus varus by first metatarsal osteotomy and appropriate ligament releases and plications to restore alignment. A detailed understanding of the pathomechanics is essential for proper interpretation of the problems and anticipated lasting surgeries.
Hallux Valgus↗
Progressive external ophthalmoplegia: a paraneoplastic manifestation of lymphoma.
PURPOSE: Paraneoplastic neurological syndromes are well-known sequelae of some malignancies. To our knowledge, a syndrome mimicking progressive external ophthalmoplegia had never been reported preceding the diagnosis of a lymphoma. CASE REPORT: A 63-year-old man developed progressive external ophthalmoplegia, without any other neurological symptoms, as the initial manifestation of a follicular lymphoma grade III. The ophthalmoplegia resolved after two cycles of combination chemotherapy. CONCLUSIONS: The ophthalmologist, when confronted with a progressive external ophthalmoplegia, should consider a neurological paraneoplastic syndrome associated with a tumor as a possible diagnosis.
Aged↗
Morphometric study of wound healing in a model of filtering surgery with mitomycin-C.
BACKGROUND: Failure of filtering surgery may be related to excessive wound healing in the surgical area. This effect diminishes with the use of antimetabolic agents. Mitomycin-C (MMC) has proved to be the most effective drug to reduce myofibroblastic proliferation in experimental in vivo and in vitro models. To our knowledge, the objective changes induced by mitomycin-C in the size of wound healing areas have not been investigated. METHODS: Filtering surgery was performed on both eyes of 40 pigmented rabbits. Preoperatively one of the eyes received MMC (0.5 mg/ml), and the fellow eye received balance salt solution as placebo. Animals were killed on days 6, 15, 30 and 58. Microscopic healing areas were measured by digital procedures. The areas of target and fellow control eyes were compared by the Wilcoxon test. RESULTS: This study showed significant differences (p < 0.05) between treated and untreated groups, the healing are a gradually becoming smaller. CONCLUSIONS: Objective methods to quantify the microscopic effects of MMC can be useful to improve our knowledge about the action on this antimetabolite and to enable us to adjust more accurately the timing and dosage when applying the drug in glaucoma filtering surgery.
Animals↗
Subconjunctival mass in Rosai-Dorfman disease.
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Aged↗
Centralized purchasing controls costs and improves profits.
The materiel manager's role requires the proper interfacing of two very important functions--purchasing and inventory control. This article explores inefficient practices that cause supply and inventory costs to rise and examines some techniques that can be applied to reduce inventory investment.
Centralized Hospital Services↗
Capital equipment negotiation: a systematic checklist.
A number of systematic procedures and guidelines can be established to provide the negotiating agent with the proper tools to achieve a cost-effective purchase. The checklist presented here is an example of one such tool which offers some important considerations for negotiating capital equipment contracts. Other considerations include qualitative analysis of competing companies, analysis of the validity of the real reasons behind the purchase, the true life of the equipment, all operating costs to be incurred, biomedical review, renovation costs, code requirements, and much more. No matter what the considerations, the purchasing agent is responsible for critiquing the overall purchase, and for performing a good value analysis. These activities can help protect the hospital from excess expense and ensure that it receives the maximum value over the life of the capital equipment purchased.
Capital Expenditures↗
Health care and the 21st century.
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Delivery of Health Care↗
[The prevalence of malnutrition in hemodialysis].
Uremic patients undergoing hemodialysis are often catabolic and malnourished. To treat malnutrition effectively, a preliminary nutritional assessment is needed. In a group of 61 chronic uremic patients undergoing maintenance hemodialysis, the authors evaluated the nutritional status with the following indices: 1) assessment of the somatic fat and protein compartments by means of anthropometric measurements (body mass index: BMI, triceps skinfold thickness: TST, and arm muscle circumference: AMC); 2) assessment of the visceral protein compartment (serum albumin); 3) assessment of cell-mediated immunity by means of skin tests and 4) assessment of the dietary intake of nutrients with dietary diaries. BMI and TST were subnormal in 57 and 72% of patients, respectively. CMB and albumin were normal in most. The protein intake was normal, whereas the energy intake tended to be low. Correlations were observed among different anthropomorphic measurements and dietary intake of nutrients. We conclude that there is a tendency to caloric, and in a lower degree protein malnutrition in our patients.
Aged↗
[Color-coded Doppler in the diagnosis of vascular complications following heart catheterization].
To determine the value of color Doppler in the diagnosis of vascular complications resulting from cardiac catheterization 5 consecutive patients, with the clinical suspicious of vascular iatrogenesis potentially requiring surgical repair, were analyzed. In 2 patients a femoral mass developed after a diagnostic catheterization but 3 patients underwent previously an interventional catheterization technique. In 3 patients color Doppler readily visualized a systolic jet originated in the femoral artery entering an anterior echo-free cavity, and a reversal flow in diastole, suggesting a femoral pseudoaneurysm. In 1 patient the clinical diagnosis of arteriovenous fistulae was confirmed by color Doppler which demonstrated a continuous turbulent flow within the femoral vein. In the remaining patient a diagnosis of simple femoral haematoma was made after the demonstration of a relatively echogenic structure overlying the femoral artery and vein but not interfering with their flows. In the 3 patients with femoral pseudoaneurysms and in the patient with arteriovenous fistulae the diagnosis was confirmed by angiography and during surgery. Our preliminary findings underscore the value of color Doppler, using the technology currently available in echocardiographic laboratories, in the differential diagnosis of vascular complications after cardiac catheterization.
Aged↗
[Kidney transplantation].
In a consecutive series of 639 Renal Transplants (RT) performed between January 1st 1978 and December 31st 1988, 75 Renal Transplanctectomies (RTX) were carried out. Of those, fifty-seven (76%) were due to immunological causes, 10 (13.3%) to vascular complications, 7 (9.3%) to urological problems and 1 (1.3%) to deep infection. The time elapsed between RTX and RT was as follows: 25 were performed earlier than 6 weeks, 17 between 6 weeks to 6 months, and 33 after 6 months. The higher number of complications did not happened, as it is frequently described, in the first group; on the contrary, it fell in the group that had been transplanted longer. There were 13 immunologically caused renal rhexis, 5 of which were RTX, another 5 were operated on and diagnosed at perioperation, and immediately received the appropriate treatment so they were able to keep their kidney, and finally, 3 patients were diagnosed a rejection with renal rhexis, ecographically confirmed. These patients were given only medical treatment, which was enough to allow jugulation of the picture. RTX techniques used were: extracapsular in 28 cases and intracapsular in 47. Surgical approach, except for 2 cases of simultaneous kidney and pancreas transplantation, was extraperitoneal.
Graft Rejection↗
[Primary malignant melanoma of the nasal cavity].
This refers to a case of a malign melanoma in the nasal cavity. Melanomas of the mucosal origin differed from the melanomas cutaneous in that size of the primary lesion did not influence prognosis. Regional lymph node metastases are rare and did not influence prognosis. Local recurrence at the primary site is frequent. Surgical treatment offers long-term cure to only a limited number of patients.
Female↗