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Biomedical subjects

S Lledó

Publications and source records attributed to S Lledó.

26 records · Page 2Linked to original sources
PubMed1995

Prevalence of pudendal neuropathy in fecal incontinence. Results of a prospective study.

PURPOSE: A prospective study was made of the prevalence and associations of pudendal neuropathy in 96 patients with fecal incontinence (72 females and 24 males). METHODS: Clinical exploration, perineal level measurement, anorectal manometry, and electrophysiologic evaluations (pudendal nerve terminal motor latency (PNTML) and external sphincter fiber density (FD)) were performed. RESULTS: Pudendal neuropathy (defined as PNTML > 2.2 ms or FD > 1.65) was found in 67 patients (69.8 percent) and was more common in females (75 percent) than in males (50 percent; P = 0.05). Pudendal neuropathy was also more frequent in patients with pathologic perineal descent (85 percent vs. 55 percent; P < 0.01) or exhibiting risk factors such as difficult labor or excessive defecatory straining (P < 0.01). Perineal level at staining correlated inversely with both PNTML and FD (P < 0.01). Manometric findings suggested greater external anal sphincter damage in patients with pudendal neuropathy than in those suffering fecal incontinence but no neuropathy (P < 0.05). Pressure caused by the striated anal sphincter was also inversely correlated to PNTML. Pudendal neuropathy was encountered in 37 of 33 (58.7 percent) patients with sphincter injury vs. in 31 of 33 (93.9 percent) patients with idiopathic fecal incontinence (P < 0.01). CONCLUSIONS: Pudendal neuropathy is an etiologic or associated factor often present in patients with fecal incontinence. In this sense, clinical, perineometric, and manometric findings correlate with pudendal neuropathy, though such explorations do not suffice to detect it.

Adolescent↗
PubMed1995

Evaluation of residual vascularisation in oesophageal substitution gastroplasty by surface oximetry-capnography and photoplethysmography. An experimental study.

OBJECTIVE: To evaluate residual vascularisation in gastroplasty and its possible relation to the development of anastomotic fistulas or dehiscences after oesophageal resection. DESIGN: Experimental open study. MATERIAL: Eleven mongrel dogs. INTERVENTIONS: Gastric parietal blood flow was evaluated by photoplethysmography and measurement of surface oxygen and carbon dioxide tensions under basal conditions and after Akiyama's tubular gastroplasty. Temperature, heart rate, and electrocardiogram; arterial pressure, pulmonary arterial pressure, pulmonary capillary pressure, central venous pressure, cardiac output, venous oxygen saturation, and arterial blood gas tensions were monitored under stable haemodynamic conditions. RESULTS: After gastroplasty, the mean serosal oxygen tension (pO2) of 8.6 mmHg and carbon dioxide tension (pCO2) of 99.5 mmHg and residual photoplethysmographic wave amplitude (8%) indicated considerable severe ischaemia at the fundus. There was relative ischaemia of the mid-stomach with residual mean values of 52.7 mmHg, 77.8 mmHg, and 57% for pO2; pCO2 and PPG wave amplitude, respectively. CONCLUSIONS: Important devascularisation of the fundus, theoretically incompatible with healing, occurs after gastroplasty. Operative photoplethysmography and surface measurements of pO2 and pCO2 are good ways of evaluating the level and degree of ischaemia in gastric tubes for oesophageal replacement.

Anastomosis, Surgical↗
PubMed1990

[Incidence of inflammatory bowel disease in Sagunto].

The incidence and prevalence of inflammatory bowel disease in the population served by the Sagunto Hospital during 1983-1989 is reported. The global incidence of IBD is 9.07 cases/100,000 inhabitants. The mean incidence of ulcerative colitis has been 4 +/- 2.15; a peak incidence of 8.2 was observed in 1985. It was 3.3 in 1989. Prevalence was 28.87/100,000 inhabitants. The mean incidence of Crohn' disease is 3.06 +/- 1.76/100,000 inhabitants/year, with an increase from 0.8 in 1983 to 5.7 in 1989. Prevalence of Crohn's disease is 21.4/100,000 inhabitants.

Adolescent↗
PubMed1987

Chemotherapy of advanced gastric carcinoma (stage IV): a randomized study of FAM versus 5-FU plus BCNU.

Forty-six patients with advanced gastric carcinoma (Stage IV) were evaluated in a prospective randomized comparison of two chemotherapy regimens (FAM versus 5-FU plus BCNU) to identify therapeutic activity. Treatment groups were well balanced with respect to known prognostic factors. Thirty-three patients had measurable disease and thirteen had only microscopic residual disease in the resection margins. The overall median survival of the entire group was 13.2 months. Two (6%) patients with measurable disease reached complete response (CR), 1 (3%) partial response (PR), 12 (36%) had stable disease (SD) and 18 (56%) had progressive disease (PD). The responders had not reached the median survival yet, the patients with SD had a median survival of 14.7 months and the PD 9.5 months. In the FAM arm there were 3 (18%) responders (2 CR and 1 PR), 7 (41%) SD and 7 (41%) PD, versus O responders, 5 (31%) SD and 11 (69%) PD in the 5-FU plus BCNU arm. In the FAM arm the median survival was 15.7 months versus 9.9 months in the other therapeutic arm. The statistical analysis indicated that survival associated with FAM regimen was superior to that reached with the 5-FU plus BCNU regimen. Thirteen patients with unmeasurable disease had a median survival of 15.9 months.

Adult↗
PubMed1980

[New experimental method for analysis of bronchopulmonary airway resistance to airflow (author's transl)].

A modified method from Macklem and Mead, to determine experimentally the central airway resistances to flow (from the trachea to the 6th-8th bronchial branch division) in the dog is described. Performed in vivo and with intact thorax it affords greater physiological conditions, which permit fractionating the value of the total airway resistances in its central and peripheral components. The method was assayed in a pharmacological model of experimental asthma, and in specimens with reversible obstruction of a main pulmonary artery produced by a balloon, and after lobar and bilateral embolism with barium sulphate. The method is selective, reproducible and precise. Its performance is good in 70-80% of cases, and it is, therefore, highly interesting for pharmacological and physiological purposes in the in vivo study of the gross airways in the intact dog.

Airway Resistance↗
PubMedDate not supplied

[Morphological, histochemical and immunochemical characteristics of the terminal ileum of patients with ulcerative colitis. Relationship with the development of pouchitis].

UNLABELLED: Pouchitis is the most frequent long-term complication of the ileoanal reservoirs. Its etiology is unknown and it is currently believed to be a recurrence of ulcerative colitis in the mucosa of the ileal reservoir. AIM: To evaluate whether the mucosa of the terminal ileum of patients with ulcerative colitis is different from that of patients free of this disease and whether there are morphological and immunological alterations which might predispose to inflammation of the reservoir. PATIENTS AND METHODS: Colectomy samples from the terminal ileum of 20 patients (12 women, 8 men) with ulcerative colitis who had undergone restorative proctocolectomy with ileoanal reservoir and of 10 controls who had undergone right hemicolectomy for other causes were studied. During follow-up (46.9 months) seven patients were diagnosed with pouchitis (Sandborn > 7). In all patients, morphometric histopathologic, histochemical and immunohistochemical studies of the ileal mucosa were performed. RESULTS: Chronic inflammatory infiltrate and the degree of villous atrophy and of global chronic inflammation were significantly higher in the terminal ileum of patients with ulcerative colitis than in the control group. There were no differences in the mucin content between the two groups and IgA, IgG and B lymphocyte expression was significantly higher in the terminal ileum of patients with ulcerative colitis. Chronic inflammatory infiltrate, degree of atrophy, villous atrophy and of global chronic infiltration, macrophage and CD8 lymphocyte expression were higher in the terminal ileum of patients with pouchitis, but differences was not significant. CONCLUSIONS: The terminal ileum of patients with ulcerative colitis has histopathologic, morphometric and immunohistochemical characteristics that are different from those of patients without this disease. These results may eventually lead to an association between alterations in the ileum and the subsequent development of pouchitis.

Adult↗
PubMedDate not supplied

[Intestinal complications from vascular prostheses].

Secondary FAE is a rare complication, usually located at the duodenum. The typical clinical presentation is like a digestive hemorrhage or a sepsis. We report two cases of FAE with atypical manifestations. The first case presented a lower digestive hemorrhage produced by the fistulization to the sigma. The second case appeared like an intestinal obliteration caused by the full emigration of a prosthesis to the jejunum. We wish to remark the importance of the clinical suspicion of a FAE (Key of diagnosis), and the sparing relevance of the complementary examinations and the urgency of a surgical treatment in order to avoid the high rate of morbi-mortality associated with this complication.

Blood Vessel Prosthesis↗