Isabel González Alemán

Universidad Central "Marta Abreu" de las Villas (UCLV)

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Noel Ernesto Pedraza Alonso

Hospital Universitario Río Hortega

Rosa Oliday Ríos Jiménez

Hospital Oncológico Docente "Conrado Benítez García"

Claudia Roche Albernas

Hospital General Universitari de Castelló

Yuneisy Ulasia Sánchez

Leonel Valdés Leiva

Universidad de Ciencias Médicas de Villa Clara

Silvianne Vargas Gutiérrez

Universitat de Miguel Hernández d'Elx

Juan Gutiérrez Ronquillo

Universidad Central "Marta Abreu" de las Villas (UCLV)

José Luis Rodríguez Monteagudo

Hospital Tobar García

Robin Rodríguez Pérez

California State University, Sacramento

Daniel Artiles Martínez

Universidad Central "Marta Abreu" de las Villas (UCLV)

Cooperative Institutions

Universidad Central "Marta Abreu" de las Villas (UCLV)

Hospital Oncológico Docente "Conrado Benítez García"

Universidad de Ciencias Medicas

Hospital General Universitari de Castelló

Universidad de Ciencias Médicas de Cienfuegos

Universitat de Miguel Hernández d'Elx

University of Milan

IRCCS Policlinico San Donato

Swedish Medical Center

University of Pisa

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Criptococosis versus altenariosis cutánea. Presentación de un paciente

Acta Médica del Centro (2014)

Isabel González Alemán Carmen Patricia Alfonso González Robin Rodríguez Pérez

It is presented a 62 year old man with a history of renal transplantation, he showed ulcerated skin lesion of mamelonants edges and months of evolution. Clinical diagnosis of pyoderma gangrenosum or squamous cell carcinoma were evaluated and a skin biopsy was performed; histopathological diagnosis concluded a cutaneous cryptococcosis, although histochemical techniques used yielded variable results. A culture of the lesion is indicated to confirm the diagnosis and proposed further rule out the possibility of cutaneous alternariosis, another common infection in immuno-compromised patient. It was emphasized in the differential diagnosis between the two fungal opportunistic infections.

Skin lesion

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Benign sclerosing stromal tumor of the ovary: report of a patient

DOAJ (DOAJ: Directory of Open Access Journals) (2013)

Isabel González Alemán Yuria del C. Suárez Ortiz Eliecer Anoceto Armiñana

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Granulomatous angiitis of the central nervous system. Autopsy Report

DOAJ (DOAJ: Directory of Open Access Journals) (2012)

Isabel González Alemán Noel Ernesto Pedraza Alonso

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[Modern algorithm for treating pudendal neuralgia: 212 cases and 104 decompressions].

PubMed (2003)

Éric Bautrant Eric de Bisschop V Vaini-Elies J Massonnat Isabel González Alemán

Clinical signs and symptoms of the pudendal neuralgia are very rich, with a great individual variability. The clinical diagnosis is difficult. It is confirmed or invalidated by the electrophysiologicals tests. Since October 1998 patient selection has been possible using a diagnosis score. Over a four-year period, the diagnosis of pudendal neuralgia was confirmed by electrophysiological investigations in 212 subjects. We rejected 12 patients because of a radiculo-medullary organic etiology. We only describe here cases of women with a peripheral pudendal nerve injury (200 patients). Thirty-eight neuropathies free of canal symptoms (obstetrical, post-traumatic...) were treated by infiltration therapy. The study of a total of 162 canal syndromes showed prevalent injury at the sacro-spino-tuberal ligamental grip which was observed in 68% of the cases, compared to the Alcock canal which was present in only 20% of the cases. One hundred four of these patients underwent surgical decompression via a trans-ischio-rectal approach after negative results of the infiltration therapy. We report here the surgical methodology, the post-op follow-up and the results, which appear quite successful: after one year 86% of the subjects are symptom-free or with a significant reduction of pain.

Pudendal nerve

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Spontaneous intracerebral hemorrhage. Necropsy study spanning a year

DOAJ (DOAJ: Directory of Open Access Journals) (2007)

Isabel González Alemán Idael Torres González Daniel Artiles Martínez Noel Pedraza Alonso Claudia Roche Albernas

Spontaneous intracerebral hemorrhage

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Meningitis por criptococo y trombosis venosa cerebral en paciente sicklémica

Isabel González Alemán Claudia Roche Albernas Betty Alonso Falcón Grethel Dueñas Ramírez Maylín Acosta Álvarez

A 47-year-old woman diagnosed with sickle cell anemia and a vaso-occlusive crisis in the brain was admitted with fever, general malaise and headache, with transient episodes of disorientation. In her evolution, there was a motor defect in the right side, dysarthria and convulsive seizures refractory to therapy. The cranial tomographic study revealed a hypodense image in the left parietal lobe in relation with an infarction, and evidence of contrast enhancement in the turns in the affected area due to cortical vein thrombosis. The patient had a torpid evolution, and died with neurological impairment and septic respiratory symptoms. At necropsy, it was concluded the presence of Cryptococcus neoformans meningitis and cerebral venous thrombosis in a sickle cell anemia patient, associated with severe bilateral bacterial bronchopneumonia that lead to her death. Infections in immunocompromised patients, and especially fungal infections, may not be suspected and may not be treated, as occurred with this patient. This fact, and the association with cerebral venous thrombosis, motivated a discussion in the clinicopathological session of the institution. The study of the autopsy is reported, as well as a review of the condition as a way of focusing attention on opportunistic fungal infections. This is another tough battleground for the diagnosis and treatment of patients, in which the main weapon is the proper use of the epidemiological-clinical method in all medical specialties – efforts must be directed that way.

Malaise

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Brain abscess

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Hemorragia intracerebral espontánea. Estudio necrópsico en un período de un año

Acta Médica del Centro (2007)

Isabel González Alemán Idael Torres González Daniel Artiles Martínez Noel Pedraza Alonso Claudia Roche Albernas

A review of 160 deceased cases with diagnosis of cerebrovascular disease and having undergone necropsy spanning a whole year was performed, in order to assess its mortality rates. A 35.6% of cases were diagnosed as intracerebral hemorrhage. The peak incidence was in the age above 60 years, and male gender was the most affected. The main cause of death was neurological in 45 cases and non-neurological in 12, being hypertension in 85.9% of cases and in only 14.1% other etiologies were involved. The most frequent location was putamen (42.1%), followed by thalamus (14%), cerebral and cerebellar hemisphere (12.2% each), centrum ovale white matter (10.5%), pons and caudatum (1.8% each). The predictive factors for a worse outcome were advanced age, hemorrhage size, the presence of ventricular flood and brain shifts.

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Linfoma primario no Hodgkin del sistema nervioso central

Isabel González Alemán Silvianne Vargas Gutiérrez Yuneisy Ulasia Sánchez José Luis Rodríguez Monteagudo Juan Gutiérrez Ronquillo

Female patient, 72 years old, diagnosed with cerebral infarction and residual hemiparesis, admitted for a worsening of motor deficits and dysarthria. The computed tomography of the skull revealed complex images suggestive of brain metastases. No primary site of origin was demonstrated in the tests performed. The patient died from acute respiratory failure. In the necropsy, it was determined a pulmonary thromboembolism and primary cerebral lymphoma as the causes of death. The low incidence of this tumor, its presentation with multiple lesions in 25 to 50% of patients and its morphologically heterogeneous aspect motivated a discussion at the clinicopathologic session. The debate was focus in setting the cronopathogram of the disease. A study of the autopsy and a review of the condition are presented as a way to get experiences in order to extend life in other patients, by sharing this fatal case, which is the fundamental objective of post-mortem studies.

Dysarthria

Presentation (obstetrics)

Hemiparesis

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Síndrome de linfohistiocitosis hemofagocítica

Acta Médica del Centro (2011)

Noel Ernesto Pedraza Alonso Isabel González Alemán Lumey Hernández Niebla Yuneisy Ulasia Sánchez Rosa Oliday Ríos Jiménez

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Non-Hodgkin primary lymphoma of the central nervous system