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W Rodríguez

Publications and source records attributed to W Rodríguez.

At least 19 recordsLinked to original sources
PubMed1999

Always remember chylothorax.

Chylothorax is a rare cause of pleural effusion in association with cardiovascular surgery. A 68-year-old man had a coronary artery bypass graft; 10 days after surgery, he had progressive shortness of breath and a massive left pleural effusion. After chylothorax was diagnosed, it was successfully treated with a thoracostomy tube and total parenteral nutrition. The patient had an uneventful recovery. Nutrition is the most important issue in the treatment of chylothorax. Once chylothorax is identified, nutritional support is the priority, since it will have an important role in the recovery of the patient. Besides our case, we hereby present a short review of the literature regarding the diagnosis and management of this rare entity.

Aged↗
PubMed1999

Asthma knowledge among internal medicine residents.

OBJECTIVES: To assess the medical knowledge about asthma among residents from the Accreditation Council on Graduate Education (ACGME) accredited Internal Medicine programs. BACKGROUND: Asthma prevalence and morbidity has increased significantly in the last 20 years. Recent morbidity data suggests that approximately 14 to 15 million Americans suffer from asthma and 5,000 of them die annually due to this illness. Previous studies have suggested that Puerto Ricans are disproportionally affected by asthma. In order to impact both morbidity and mortality relates to asthma, primary care givers should be knowledgeable about the disease. METHODS: Based in the 1993 National Heart, Lung and Blood Institute (NHLBI) guidelines, a questionnaire was developed to evaluate the knowledge of asthma in physicians in the Internal Medicine Residency Programs. It consisted of 27 questions covering the areas of diagnosis and treatment of asthma. RESULTS: The questionnaire was answered by 90% of the 138 residents active at the moment of the study. Fifty-one percent of the residents failed to obtain a score of 70% or greater. Score on asthma diagnosis was less than 70% and did not improve through year of training. Score obtained on asthma treatment improved through training year although no statistical difference was obtained. CONCLUSIONS: In view of these results it is imperative to reinforce the state of the art asthma education of physicians. Research initiatives must evaluate educational strategies to improve asthma education.

Asthma↗
PubMed1999

Occult aspiration of a chicken wishbone as a cause of hemoptysis.

Aspiration of foreign bodies is more common in children than adults. The clinical and radiological findings between these two age groups are different. It is a clinical diagnosis often overlooked in adults. We hereby present an elderly male patient who was referred to us due to a one year history of hemoptysis. He was heavy smoker, so the initial working diagnosis was malignancy. Upon bronchoscopic evaluation, a foreign object was found which is very uncommon in adults. The unusual location of the aspirated material is another interesting feature of our case. Clinicians should be aware that aspiration of foreign objects may occur also in adults.

Aged↗
PubMed1999

Tuberculosis prevention questionnaire: common practices among pulmonary medicine and infectious disease specialists in Puerto Rico.

A survey about tuberculosis infection status, surveillance and protection practices among pulmonologists and infectologists was performed.A fourteen-item questionnaire was mailed. The survey was addressed to 108 pulmonologists and 61 infectologists. Responses were collected from 35 pulmonologists (32%) and 18 infectologists (29%). Sixteen out 35 pulmonologists had a positive tuberculin test (TST) (46%). Nine of fourteen took at least 6 months of preventive therapy with isoniazid when converted. Three out of eighteen infectologists had a positive TST. 63% of the pulmonologists and 38% of the infectologists evaluate their TST every 12 months. 40% of the pulmonologists and 66% of the infectologists answered that they treat more than ten patients with tuberculosis annually. Interestingly, 50% of the responder bronchoscopists use surgical masks instead of recommended HEPA filter masks. 73% of the responders reported not having negative pressure rooms when performing procedures. Despite stamped-addressed envelopes and the relation of these professionals with the related issue, low participation was observed.Among the responders a low frequency of TST was observed, especially in those exposed to higher-risk procedures. Non-adequate facilities and lack of use of protective equipment was reported. Even though not representative of the entire medical community the results of this survey are concerning regarding educational and safety policies of our professionals and institutions.

Antitubercular Agents↗
PubMed1998

Risk factors for treatment-related death in elderly patients with aggressive non-Hodgkin's lymphoma: results of a multivariate analysis.

PURPOSE: It has been suggested that age is associated with chemotherapy-related death in patients with non-Hodgkin's lymphoma (NHL) treated with doxorubicin-containing chemotherapy. The purpose of this study was to evaluate the relative influence of increasing age and other clinical parameters on the occurrence of treatment-related death in elderly patients with intermediate- or high-grade NHL treated with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) chemotherapy. METHODS: A retrospective study of patients 60 years of age or older with intermediate- or high-grade NHL treated with CHOP chemotherapy in a single cancer center. The following variables were recorded: age (60 to 69, 70 to 79, and 80 to 94 years), histology (Working Formulation [WF] D, E, F, G, and H), Ann Arbor stage, B symptoms, extranodal involvement, bulky disease (> 7 cm), performance status (Eastern Cooperative Oncology Group [ECOG] scale), International Prognostic Index (IPI score), serum lactate dehydrogenase (LDH) level and doxorubicin relative dose-intensity (RDI). The relationship between these features and treatment-related death was assessed in univariate and multivariate logistic regression analysis. RESULTS: From 1982 to 1991, 267 consecutive patients were treated. Median age was 70 years (range, 60 to 94 years). There were 35 toxic deaths. Sixty-three percent of the deaths occurred after the first cycle. Infection accounted for 82% of the toxic deaths. In the univariate analysis, the features associated with an increased risk of toxic death were ECOG performance status 2 to 4 (relative risk [RR], 7.82), B symptoms (RR, 3.38), diffuse large-cell histology (RR, 3.06), bulky disease (RR, 2.58), serum levels of LDH (RR, 2.53), and IPI score (RR, 2.46). The age groups did not show significance. In the regression model, performance status 2 to 4 was the only independent predictor of treatment-related death (RR, 3.52; 95% confidence interval [CI], 2.98 to 4.06). CONCLUSION: Our results show that in elderly patients with NHL treated with doxorubicin-based chemotherapy the risk for treatment-related death is associated with poor performance status rather than with increasing chronologic age.

Age Factors↗
PubMed1996

[Lipoprotein in children and adolescents: relationship with family history of coronary artery disease].

BACKGROUND: Lipoprotein (a) is considered an independent cardiovascular risk factor. AIM: To study lipoprotein (a) levels in children of 18 years old or less with or without family history of coronary artery disease. SUBJECTS AND METHODS: Forty four children aged between 3 and 18 years old with a family history of coronary artery disease and 44 age and sex matched controls were studied. A fasting blood sample was obtained to measure total, HDL and LDL cholesterol, triglycerides, A1 and B apoproteins and lipoprotein (a). RESULTS: Compared to controls, children with a family history of coronary disease had higher total cholesterol (177 +/- 35 and 159 +/- 23 mg/dl respectively), LDL cholesterol (112 +/- 34 and 94 +/- 21 mg/dl respectively), triglycerides (89 +/- 38 and 71 +/- 25 mg/dl respectively), apoprotein B (85 +/- 17 and 65 +/- 13 mg/dl respectively) and lipoprotein (a) (40 +/- 50 and 22 +/- 31 mg/dl respectively). Thirty two percent of children with positive family history had lipoprotein (a) levels over 30 mg/dl, compared to 23% of controls. CONCLUSIONS: Children with family history of coronary artery disease have higher levels of cholesterol, triglycerides and lipoprotein (a) than matched controls.

Adolescent↗
PubMed1991

Mutation analysis of glucose-6-phosphate dehydrogenase (G6PD) variants in Costa Rica.

Glucose-6-phosphate dehydrogenase (G6PD) deficiency has previously been reported among both the black and white populations of Costa Rica. All 28 G6PD A- samples were found to be of the common G6PD A-376G/202A type. A previously described mutation associated with nonspherocytic hemolytic anemia, G6PD Puerto Limón, was found to be due to a G----A transition at nucleotide (nt) 1192, causing a glu----lys substitution. Mutations in this region of the G6PD molecule seem invariably to be associated with chronic hemolytic anemia. G6PD Santamaria had been described previously in two unrelated white subjects. We found that both did, indeed, have the same mutations. In this variant the A----G substitution at nt 376 that is characteristic of G6PD A was present, but an A----T mutation at nt 542, apparently superimposed on the ancient G6PD A mutation, resulted in an asp----val substitution. Thus, the gain of a negative charge at amino acid 126 was counterbalanced by the loss of a charge at amino acid 181, giving rise to a variant with the G6PD A mutation but with normal electrophoretic mobility.

Black People↗
PubMed1989

[Hereditary persistence of fetal Hb and its association with Hb S. 1st case found in Costa Rica].

An electrophoretic pattern of Hb S + Hb F, the relative concentration of this last being 37%, was found in a phenotypically mestizo 3 year-old child of Costa Rica. The genotype of the child was G gamma/A gamma, with a ratio of 1:1. Both hereditary alterations were disperse, according to the family study performed, which showed Hb S plus hereditary persistence of foetal haemoglobin of the African type G gamma A gamma (delta beta o). This case is briefly discussed, along with the molecular heterogeneity of HPFH and the importance of the differential diagnosis of electrophoretic patterns found in Hb S + Hb F patients.

Anemia, Sickle Cell↗
PubMed1986

Gay bowel syndrome.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Characterization of Neisseria gonorrhoeae strains isolated from patients with conjunctivitis.

The conjunctivitis produced by Neisseria gonorrhoeae is the less frequently reported clinical form of gonococcal infection. We aim to phenotypically characterize N. gonorrhoeae isolated from conjunctivae sites. A total of six cases of this disease were notified in the Camagüey province, Cuba. All the strains isolated were penicillin-producing, showed the serogroup WI and exhibited the same antimicrobial susceptibility pattern and plasmid profile (2.6-3. 2-24.5). The results contribute to the characterization of N. gonorrhoeae strains circulating in our environment.

Adult↗
PubMedDate not supplied

[Risk factors of cardiovascular disease in a Chilean school population: I: Blood lipids in 552 children and adolescents 6-15 years of age].

The distribution of serum cholesterol (TC), low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL)-cholesterol and triglycerides (TG), and the prevalence of risk-considered values were studied in school children from Concepción, Chile (6 to 15 years old; 326 boys, 226 girls). The mean TC levels were 146 mg/dl for boys and 154 mg/dl for girls but 9.1% of the sampled children had TC values between 175 and 190 mg/dl, and 10% were over 190 mg/dl. Mean LDL-C was 83 mg/dl in boys and 89 mg/dl in girls; 6% of samples showed values between 130 and 159 mg/dl, and 1.3% over 160 mg/dl. Mean HDL-C was 46 mg/dl for boys and 48 mg/dl for girls. The mean TG values were 80 mg/dl for boys and 93 mg/dl for girls.

Adolescent↗