[Shock of rapidly catastrophic course in a chronically alcoholic and diabetic 49-year-old male].
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Alcoholism↗
Biomedical subjects
S Serrano
Publications and source records attributed to S Serrano.
Spinal intraosseous arteriovenous malformation as a cause of juvenile scoliosis. A case report.
STUDY DESIGN: A case report. OBJECTIVES: To report and discuss an unusual case of scoliosis resulting from an arterial malformation of the spine. SUMMARY OF BACKGROUND DATA: This is a report of clinical manifestation, physical findings, computed tomography scan, magnetic resonance imaging, bone scan, and results after surgery in an 8-year-old boy with a painful scoliosis resulting from an intraosseous arteriovenous malformation of the spine. METHODS: Radiographs, computed tomography scan, magnetic resonance imaging, and bone scans were studied and oriented us to the diagnosis of scoliotic attitude secondary to a benign-appearing tumor in the right lamina of L4. Surgery was performed through a posterior midline approach to remove the lesion en bloc. Postoperative treatment was performed with a Boston orthosis. RESULTS: Final pathology reports diagnosed an intraosseous arteriovenous malformation. After 32 months, the boy had no pain, and scoliotic attitude diminished despite radiographs still showing a single 10 degrees right lumbar curve. CONCLUSIONS: Primary intraosseous arteriovenous malformations are rare. This case shows the scarce specificity of clinical findings, radiology, and bone scan in the diagnosis of these lesions when they are localized in vertebral territory. Surgical excision of the lesion relieves pain but does not completely correct the scoliotic attitude.
Arteriovenous Malformations↗
Effects of linoleic acid supplements on atopic dermatitis.
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Adult↗
Acute effects of ethanol on mineral metabolism and trabecular bone in Sprague-Dawley rats.
In order to assess the effects of acute ethanol intoxication on bone, 45 female Sprague-Dawley rats were studied. Five rats were sacrificed at baseline. The remainder received either ethanol (2 g/kg of body weight) intraperitoneally or isotonic saline. Rats were sacrificed in groups of 10 (5 intoxicated and 5 placebo) at 1, 4, 8, and 24 hours after injection. At the time of sacrifice, a blood sample was obtained and the 4th vertebra was excised for histomorphometric analysis of undecalcified bone. Effect of ethanol was assessed by an analysis of variance test using a Scheffé procedure. In ethanol-treated rats we observed (mean +/- SD, ethanol versus controls, maximum difference point, P value) a significant decrease in osteiod surface with osteoblasts (42.86 +/- 15.61% versus 64.57 +/- 6.24%, P < 0.05); osteoclast number (0.05 +/- 0.02 n/mm2 versus 0.17 +/- 0.09 n/nm2, P < 0.05), and osteocalcin (36.9 +/- 2.21 ng/ml versus 45.8 +/- 5.1 ng/ml, P < 0.05). Osteoclast surface was initially reduced (0.129 +/- 0.09% versus 0.425 +/- 0. 26%, P < 0.01) but showed a subsequent increase (0.765 +/- 0.24% versus 0.226 +/- 0.17%, P < 0.01) attributable to alcohol. There was also a significant decrease in serum Ca (8.51 +/- 0.23 mg/dl versus 9.10 +/- 0.29 mg/dl, P < 0.01) and parathyroid hormone values (23.51 +/- 5.72 pg/ml versus 76.39 +/- 11.66 pg/ml, P < 0.001). We conclude that acute alcohol intoxication in rats induces early striking changes in bone histology and analytical parameters, not completely reversed after 24 hours. These data are consistent with a toxic effect induced by alcohol on bone.
Acid Phosphatase↗
Thymoma associated with CD4+ lymphopenia, cytomegalovirus infection, and Kaposi's sarcoma.
A case of thymoma with associated opportunistic infections, CD4/CD8 T-lymphocyte imbalance, low CD4-positive T-lymphocyte counts and Kaposi's sarcoma (KS) without HIV infection is reported. Cytomegalovirus inclusions were identified in the nuclei of some KS spindle and endothelial cells. It is known that KS has a high prevalence in AIDS patients and has occasionally been associated with other causes of immunosuppression. In previous studies, coexisting KS and thymoma were related to myasthenia gravis, corticosteroid treatment and excess CD8-positive T-lymphocyte counts. More recently an imbalance between CD4 and CD8 positive T lymphocytes has been identified in association with thymoma. The present case suggests that there may be a relationship between thymoma, CD4-positive lymphopenia, and KS.
Aged↗
[New prospects in cystic fibrosis treatment].
Only a few years ago, cystic fibrosis (CF) was considered the most frequent genetic disease in childhood, although survival has increased considerably in recent years owing to improved treatment. We discuss treatments that are still relevant as well as others that are under investigation now, aiming for better understanding of the disease and the therapies that have improved quality of life for CF patients.
Cystic Fibrosis↗
[Evolution of the bibliometric indicators of production and consumption of Archivos de Bronchopneumología in the last 20 years].
The aim of this study was to evaluate the evolution of bibliometric indicators for authorship and citation of ARCHIVOS DE BRONCONEUMOLOGIA over the past 20 years. At least 16 articles reporting new research or case reports were analyzed for every other year from 1976 to 1996. The following data were collected for each article: type of document, number of authors and their place of work and specialty, time interval between acceptance and publication, and references (including number, types, language, journal name and year of publication). The number of authors per article (collaboration index) averaged around five and has not varied significantly over the 20 years studied. Pulmonologists predominated among the authors, accounting for about 60% of the total, and most contributions came from a few provinces, mainly Barcelona and Madrid. The interval between reception and publication has gradually increased over the 20 years under review, coming to stand around 9.9 +/- 1.6 months in 1996. Most references (over 80%) cite journals and the proportion of references to books has decreased in recent years (from 12.3% in 1976 to 3.5% in 1996). The journal's index of isolation has increased (from 6.2 to 12.1%), as has the index of self-citation (from 0.4 to 6.2%). Although most cited works are in English (over 80%), the proportion of Spanish-language references increased (from 6.2 to 12.1%). In conclusion, maintenance of the number of collaborating authors, the predominance of journals and English-language sources among references are the main traits that characterize the bibliometric indicators for authorship and citation in ARCHIVOS DE BRONCONEUMOLOGIA.
Authorship↗
Social work at the emergency department.
We have evaluated the level of satisfaction of patients assigned to a social worker whose role was to give information, support, advice, grief and shock counselling; and develop resource strategies for marginal peoples. Six hundred patients were admitted to the study; 300 of them were supervised by a social worker (group A) and the other 300 were not (group B). After the completion of the study, a questionnaire was sent to be filled in by group A and group B for later evaluation. We collected 200 completed questionnaires (33.3%). The most important areas were: 105 patients (94.5%) in group A vs. 73 patients (82%) (p < 0.005) consider the medical care good or very good. The waiting time was assessed as short or acceptable in 91 patients (81.9%) in group A vs. 55 patients (61.8%) in group B (p < 0.001). The psychosocial care was assessed as very good or good in 101 patients group A (90.9%) vs. 73 patients in group B (82%) (p < 0.5).
Emergency Service, Hospital↗
Nocturnal arterial oxygen desaturation secondary to a sphenoidal meningioma.
We report the case of a nonobese and nonsmoking 51-year-old man with nocturnal arterial oxygen desaturation that returned to normal after sphenoidal meningioma resection. He presented an important daytime hypersomnia and episodes of nocturnal apnea, without snoring. His arterial blood gases, mechanical properties of the respiratory system pulmonary diffusing capacity and chemosensitivity were normal. The most frequent causes of nocturnal hypoxemia are examined.
Blood Gas Analysis↗
Comparison of helium dilution and plethysmographic lung volumes in pregnant women.
The multibreath helium equilibration method is the technique recommended for routine measurement of static lung volumes in normal subjects. However, pregnancy could be an exception to this general rule, due to airway closure during the second half of gestation. The aim of this study was to compare the measurements of lung volumes by plethysmography and helium dilution during pregnancy. Twenty three healthy women were studied at 12, 24 and 36 weeks of pregnancy, and 4 months postpartum. Total lung capacity (TLC), functional residual capacity (FRC) and residual volume (RV) were measured by multibreath helium equilibration (TLCHe, FRCHe and RVHe) and by plethysmography (TLCbox, FRCbox and RVbox). Only at 36 weeks were there differences between the two methods. RVbox was significantly larger than RVHe (1.01+/-0.18 vs 0.77+/-0.21 L; p<0.001). FRCbox was larger than FRCHe (1.95+/-0.32 vs 1.60+/-0.32 L; p<0.001) and TLCbox was larger than TLCHe (4.83+/-0.52 vs 4.45+/-0.51 L; p<0.05). The 95% limits of agreement for differences between lung volumes measured by the two techniques (helium dilution - plethysmography) at 36 weeks were: -0.42 to -0.06 L for RV; -0.54 to -0.17 L for FRC; and -0.66 to -0.11 L for TLC. We conclude that using the multibreath helium equilibration method to measure lung volumes in at-term pregnant women results in underestimation of functional residual capacity and total lung capacity.
Adult↗
Osteoblastic proliferation in bone biopsies from patients with end-stage chronic renal failure.
Osteoblasts have traditionally been considered to be terminally differentiated cells and therefore unable to divide. Data in recent years, however, indicate that cellular differentiation does not usually preclude preservation of proliferative ability and that most differentiated cells are able to divide under adequate stimuli. The aim of this study was to assess whether cubic osteoblasts undergo proliferation during the formation phase of the remodeling cycle under a stimulus that increased bone turnover. For that purpose, the osteoblastic proliferation index (OPI) was analyzed by DNA image cytometry in transiliac bone biopsies from 33 patients with chronic renal failure (23 men, 10 women; mean age 50.4 +/- 15.1 years) who have been classified into low (n = 13), normal (n = 15), and high (n = 15) bone turnover according to activation frequency (Ac.f). OPI was significantly higher (p < 0.002) in the high bone turnover group (13.90 +/- 4.72%) compared with the low (2.38 +/- 4.13%) and normal turnover groups (2.84 +/- 4.04%). There was a positive correlation between OPI and the following histomorphometric parameters: bone formation rate, surface referent (r = 0.76, p = 0.00001), activation frequency (r = 0.73, p = 0.00001), mineral apposition rate (r = 0.73, p = 0.00001), bone formation rate, volume referent (r = 0.71, p = 0.00001), and mineralizing surface (r = 0.62, p = 0.0001). This study shows that a rise in bone turnover is associated with a marked increase of bone-forming cell proliferation in patients with end-stage chronic renal failure. From this finding, it may be concluded that cubic osteoblasts do not behave as "terminally differentiated" cells in vivo, because a high proportion of them are still able to divide.
Adult↗
Sun exposure, pigmentary traits, and risk of cutaneous malignant melanoma: a case-control study in a Mediterranean population.
The main objective of this study was to assess the influence of sun exposure and pigmentary traits on the risk of cutaneous malignant melanoma (CMM) in a Mediterranean population (Andalusia, southern Spain). Cases and controls were selected from 1988 to 1993. The study population included 105 incident cases with non-familial CMM (ICD-9 code 172) and 138 controls aged 20 to 79 years. Data were collected by personal interview, and melanocytic nevi were counted over the entire body surface. Crude, and multiple-risk factor adjusted, odds ratios (OR) and their 95 percent confidence intervals (CI) were computed. After adjustment, the major constitutional risk factor was skin type I-II (OR = 29.8, CI = 8.9-100) compared with skin type V. Statistically significant and positive trends were observed between the risk of CMM and occupational sun exposure of the skin (P = 0.003), recreational exposure (P < 0.001), and cumulative lifetime sun exposure (P < 0.001). Several characteristics related to sun exposure during summer increased the CMM risk, e.g., episodes of blistering sunburns and the number of sunbaths in childhood. Use of sunscreens and spending summer holidays in places other than beach were associated with a lower risk of CMM. Regarding pigmentary traits, CMM significantly occurred with more frequency in individuals with a high degree of freckling and quoted numbers of melanocytic nevi. In conclusion, the results support sun exposure and pigmentary traits (skin type, melanocytic nevi, and freckles) as main risk factors for CMM in this population.
Adult↗
Bone metaplasia of urothelial mucosa: an unusual biological phenomenon causing kidney stones.
A kidney stone was analyzed by infrared spectrometry, by petrography using ground slices, and by undecalcified histology. Infrared spectrometry showed that the stone was composed of calcium oxalate monohydrate (whewellite), calcium oxalate dihydrate (weddellite), and calcium phosphocarbonate (apatite). Optical microscopy of the ground sections revealed tissue fragments within the stone containing small spaces resembling empty osteocyte lacunae. Histological analysis of methacrylate-embedded sections confirmed the presence of an area of heterotopic ossification. Urothelial mucosa is potentially capable of inducing bone formation and in this case the bony tissue had apparently functioned as a nucleation site for the calculus.
Adult↗
Bone remodeling alterations in myelodysplastic syndrome.
There is a close relationship between hematopoietic bone marrow and bone cells. Thus, the profound derangement of hematopoiesis in myelodysplastic syndromes (MDS) might be expected to affect bone cell function. We studied the dynamic histomorphometric changes in bone in 22 MDS patients to examine this relationship and analyze the influence of hematological disease on bone remodeling. Bone-regulating hormones and histomorphometry of undecalcified transiliac bone biopsies, after double tetracycline labeling, were studied. Serum calcium, phosphorus, creatinine, alkaline phophatase, osteocalcin, iPTH, 25(OH)D3, 1,25(OH)2D3, hydroxyprolinuria, and calcium/creatinine ratio in urine were normal compared with controls. Histomorphometry showed a significant decrease in osteoblast surface (Ob.S/BS) (0.30 +/- 0.40 vs. 0.8 +/- 1.1, p = 0.031), wall thickness (W.Th), (22.03 +/- 5.5 vs. 31.8 +/- 5.8, p < 0.005), osteoclast number (N.Oc/T.Ar) (0.004 +/- 0.01 vs. 0.017 +/- 0.01, p = 0.03), mineral apposition rate (MAR) (0.16 +/- 0.15 vs. 0.53 +/- 0.19, p < 0.005), bone formation rate, surface referent (BFR/BS) (0.004 +/- 0.10 vs. 0.016 +/- 0.016, p = 0.009), and activation frequency (Ac.f) (0.06 +/- 0.07 vs. 0.21 +/- 0.23, p = 0.008). An increase in mineralization lag time (MLT) (119.2 +/- 78.6 vs. 29.6 +/- 77, p < 0.005), (mean +/- SD, unpaired Student t-test) was observed. Bone volume (BV/ TV), eroded surfaces (ES/BS), and osteoid thickness (O.Th) remained unchanged. This picture of adynamic bone with decreased mineral apposition rate and markedly decreased osteoclast number is a characteristic finding in MDS patients. Thus, bone histomorphometric finding in MDS patients show the relationships and interactions between hematopoietic and bone cells.
Aged↗
Increased radionuclide uptake on bone scintiscans: a common but not clinically significant finding for human immunodeficiency virus type 1-infected patients free of osteoarticular symptoms.
The aim of this study was to describe findings of bone scintiscans and their clinical significance for patients infected with human immunodeficiency virus type 1 (HIV-1); 33 HIV-1-infected patients (22 men and 11 women) free of osteoarticular symptoms were included in the study. Plain bone roentgenograms, bone mineral contents (measured by dual-photon absorptiometry), and scintiscans (determined with 99mTc diphosphonate) were obtained for all subjects. Plain bone roentgenograms showed no abnormalities, and bone mineral contents were within the normal range for all patients. Radionuclide bone scans were unremarkable for eight patients (24%) and showed symmetrical abnormally increased uptake in the epiphyseal region of the appendicular skeleton in 25 (76%). Follow-up of the patients for > or = 1 year ruled out subsequent development of osteoarticular disorders. Generalized, symmetrical increased radionuclide uptake on bone scans is a common finding for HIV-1 infected patients free of osteoarticular symptoms. This finding is probably related to bone marrow hypercellularity and is of no clinical significance; therefore, other diagnostic procedures are not required in the workup of these patients.
Adolescent↗
DNA amplification in glial cells of progressive multifocal leukoencephalopathy: an image analysis study.
JC virus (JCV), the agent of progressive multifocal leukoencephalopathy (PML), has been shown by both immunohistochemistry and flow cytometry to be associated with p53 protein stabilization. Since stabilization/inactivation of p53 is associated with the development of genomic instability, abnormal cell DNA contents are to be expected in JCV-infected cells of PML. This work explores that possibility by image analysis evaluation of DNA content in PML-infected oligodendrocytes and bizarre astrocytes. Brain paraffin sections of PML lesions from five adult male patients with the acquired immune deficiency syndrome (AIDS) were treated with the Feulgen technique to obtain a stochiometric staining of DNA and analyzed with a microscope image processor. Inclusion-bearing oligodendrocytes exhibited near tetraploid DNA indices in each of the five cases, whereas atypical astrocytes were in the hypertetraploid range in all cases and were polyploid in four instances. This evidence of DNA amplification in PML glial cells is congruent with the functional abolition of p53 protein in association with JCV infection and lends further support to the role of p53 as a keeper of diploid status and guardian of genomic stability.
Adult↗
Bone remodelling in human immunodeficiency virus-1-infected patients. A histomorphometric study.
The aim of this study was to identify and describe possible alterations of bone histomorphometry in patients with human immunodeficiency virus (HIV-1) infection and to assess the relation between these alterations and disease severity. Forty-four HIV-1-infected patients seen successively at our hospital were evaluated for the study. In an attempt to avoid confounding factors as far as possible, we excluded patients who fulfilled any of the following criteria: age less than 18 or greater than 40 years; recent history of extended bed rest; previous diagnosis of metabolic bone disease, renal insufficiency, or hepatic failure; clinical or echographic signs of liver cirrhosis; diabetes mellitus or previous diagnosis of other endocrine diseases; drug therapy that could act on bone metabolism; and/or moderate to severe nutritional alteration. Twenty-two patients (13 men, 9 women; age: 27.9 +/- 4.1 years, mean +/- standard deviation) were included in the study. Plasma and urine biochemistry and calcium-regulating hormones were determined. Bone mineral content was measured on vertebrae L2 to L4 and on the neck and intertrochanteric areas of the femur by dual-photon absorptiometry. A transiliac bone biopsy was performed after double-tetracycline labelling, with histomorphometric study of undecalcified bone. Serum osteocalcin was found to be lower in patients who, according to the Centers for Disease Control (CDC) classification, had greater disease severity, and showed a positive correlation with the number of CD4+ T lymphocytes. No alterations in bone densitometry were observed.(ABSTRACT TRUNCATED AT 250 WORDS)
Absorptiometry, Photon↗