Berná Serna, Juan De Dios

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Berná Serna, Juan De Dios

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Ultrasound therapy in rectus sheath hematoma
(Oxford University Press, 2005-04-01) Sánchez Garre, Juan; Madrigal, Manuel; Zuazu, Isabel; Berná Mestre, Juan de Dios; Berná Serna, Juan De Dios; Dermatología, Estomatología, Radiología y Medicina Física
Ultrasound (US) is one of the most common modalities used in intervention for musculoskeletal disorders, although its effectiveness is debated. The purpose of this case report is to describe the intervention, including the use of US, in the management of a large rectus sheath hematoma (RSH) in a patient receiving anticoagulant therapy. The patient was a 62-year-old woman with RSH who was receiving oral anticoagulant therapy and had a history of bouts of coughing. Computed tomographic scans verified the diagnosis of RSH. The report describes the patient examination, management, intervention, and outcomes. The intervention, including the use of US therapy, may have enabled a rapid resolution of the hematoma. This case report illustrates how US may be a useful modality for complementary management of RSH, helping the reabsorption of the hematoma.
Open Access
A new treatment for mammillary fistulas using ultrasound-guided percutaneous needle electrolysis
(MDPI, 2020-02-28) García Vidal, José Antonio; Escolar Reina, María P.; Medina Mirapeix, Francesc; Guzmán Aroca, Florentina; Piñero Madrona, Antonio; Berná Mestre, Juan de Dios; Berná Serna, Juan De Dios; Fisioterapia
The aim of this study was to investigate the efficacy of ultrasound-guided percutaneous needle electrolysis (PNE) in mammillary fistulas (MFs). A prospective study was performed in 18 patients with MF who were treated with the PNE technique. The technique was repeated in the case of no response or recurrence. The results obtained show that MFs revealing an elongated appearance with the ultrasound (US) are generally resolved with two sessions of PNE, whereas ovoid MFs require several sessions of PNE for complete resolution and they tend to recur. Success of the treatment with PNE was observed in 88.8% of the patients (16/18), and failure, after five or six sessions in two cases (11.2%), which were referred for surgery. Conclusions: To the best of our knowledge this is the first study to reveal that the PNE technique is safe, effective, quick, and well-tolerated by patients.
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Is sonoelastography a helpful method of evaluation to diagnose Sjögren's syndrome?
(Wiley, 2019-02-01) Pina Frank; Aniorte Alegria Angela; Gálvez Jose; López Jornet, María Pía; Berná Mestre, Juan de Dios; Berná Serna, Juan De Dios; Dermatología, Estomatología, Radiología y Medicina Física; Facultades de la UMU::Facultad de Medicina
Objective: A new sonoelastography technique – virtual touch tissue quantification of acoustic radiation force impulses (ARFI) – offers a promising method for measuring tissue rigidity. The aim of this study was to assess the usefulness of ARFI for diagnosing Sjögren's syndrome (SS). Methods: This transversal prospective study included 41 patients with SS according to American‐European Consensus Group (AECG) criteria, and a control group without symptoms. All subjects underwent ARFI high‐resolution ultrasound assessment of the parotid glands (PG) and submandibular glands (SMG). Results: In patients with SS, parotid gland shear wave velocity (SWV) was 2.08 m/s ± 0.55, significantly higher than in control subjects (1.2 m/s ± 0.17) (P = 0.0001); submandibular gland SWV was higher in SS patients (2.12 m/s ± 0.44) than control subjects (1.56 m/s ± 0.16) (P = 0.001). Conclusions: Acoustic radiation force impulses sonoelastography can assist diagnosis of SS, and is a non‐invasive and fast method of detecting pathological changes to the parotid and submandibular glands.
Open Access
Valoración de respuesta de la enfermedad hepática mediante elastografía ARFI en pacientes con VHC tratados con antivirales de acción directa
(Universidad de Murcia, 2019-01-11) López Banet, Elena; Berná Serna, Juan De Dios; Abellán Rivero, María Dolores; Berná Mestre, Juan de Dios; Escuela Internacional de Doctorado
La infección por el virus de la hepatitis C (VHC) es un problema de salud pública que puede condicionar un daño crónico del parénquima hepático. La enfermedad hepática puede progresar hasta una extensa fibrosis y cirrosis que incrementa el riesgo de desarrollar carcinoma hepatocelular. La reciente aparición de nuevas terapias antivirales ha revolucionado el manejo clínico de los pacientes. Los fármacos de acción directa han demostrado tener más eficacia que los tratamientos clásicos con menos efectos secundarios. La respuesta viral sostenida verificada tras la terapia indica la curación de la infección, sin embargo, no existen datos concluyentes sobre el impacto del tratamiento en la historia natural de la enfermedad hepática, que constituye el principal factor pronóstico de la infección. Tradicionalmente se ha considerado que la biopsia hepática era la prueba de elección para valorar la fibrosis parenquimatosa secundaria a la infección por VHC. No obstante, esta técnica ya se ha sustituido en la práctica clínica diaria por la combinación de métodos no invasivos capaces de predecir de manera inocua el grado de fibrosis del hígado, entre los que destaca la elastografía ARFI. Esta técnica permite valorar de forma no invasiva y rápida la rigidez del parénquima hepático, que se relaciona con el grado de inflamación y fibrosis. Actualmente se cuestiona su utilidad para monitorizar la enfermedad hepática en pacientes tratados. El objetivo de nuestro trabajo era analizar la respuesta hepática al tratamiento antiviral mediante el uso de parámetros analíticos, ecográficos y elastográficos. Para ello se realizó un estudio prospectivo en el que se incluyeron 104 pacientes con VHC a los que se les realizó una evaluación basal y post-tratamiento a los 12 meses de finalizar la terapia. Los resultados obtenidos demostraron una respuesta viral sostenida en todos los pacientes. Además, se verificó una mejoría de parámetros analíticos de inflamación y fibrosis hepática y una reducción de la alfafetoproteína. Con la ecografía abdominal se detectó una menor presencia de esplenomegalia después de la terapia. Mediante elastografía ARFI se identificó una reducción de la rigidez hepática y una disminución del grado METAVIR, que se atribuyen tanto a una regresión de la fibrosis como a una disminución de la inflamación hepática. Los hallazgos descritos ponen de manifiesto la regresión del daño del parénquima hepático tras el tratamiento antiviral, así como la utilidad de la técnica ARFI en la monitorización de la respuesta a la terapia.
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Percutaneous management of breast abscesses. An experience of 39 cases
(Elsevier Science Ltd., 2004-01-01) Madrigal, Manuel; Berná Mestre, Juan de Dios; Berná Serna, Juan De Dios; Dermatología, Estomatología, Radiología y Medicina Física
This is a review of our experience with percutaneous drainage by means of needle aspiration or catheter drainage of breast abscesses under ultrasound (US) guidance, and a suggested management algorithm. A retrospective study of the 39 patients (36 women, 3 men; mean age: 28.9 years) with breast abscesses who were treated by percutaneous US-guided procedures over a period of 13 years (1989 to 2002) was carried out. Of the 36 women, 34 were nonlactating and two lactating. Needle aspiration was used in the cases of fluid collections < 3 cm and catheter drainage in fluid collections of > 3 cm. Postdrainage care and US evolutive controls were carried out on an outpatient basis. Fine-needle aspiration cytology was performed in masses unresolved after postdrainage. Mammography was performed in patients over 30 years old. In all cases, US examination revealed images of fluid collection. A single needle aspiration was sufficient in 19 cases; 3 patients needed a second aspiration to resolve the breast abscess. A total of 15 cases were resolved by means of percutaneous catheter drainage. In 2 of the 17 patients who underwent catheter drainage, the mass persisted postdrainage; histologic findings showed a chronic abscess requiring surgical intervention in one and a breast carcinoma in the second. Mean follow-up was 8.4 months. Recurrence of breast abscess occurred in 4 patients, and these were resolved by surgical excision. Percutaneous drainage procedures in breast abscesses are a safe and effective alternative to incision and drainage. Needle aspiration is employed in cases of small abscesses and catheter drainage in abscesses larger than 3 cm. Although, in chronic abscesses, the treatment of choice is surgical excision, percutaneous drainage remains as an intermediate therapeutic option.
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Osteochondritis dissecans of the knee. Sonographically guided percutaneous drilling
(Wiley, 2008-02-01) Martinez, Francisco; Reus Pintado, Manuel; Berná Mestre, Juan de Dios; Berná Serna, Juan De Dios; Dermatología, Estomatología, Radiología y Medicina Física
Objective: The purpose of this study was to present a procedure for sonographically guided percutaneous drilling in the treatment of a case of osteochondritis dissecans (OD) of the knee. Methods: A 14-year-old boy had OD of the external femoral condyle. Conventional radiography, magnetic resonance imaging, and sonography revealed the osteochondral lesion. Results: This study showed the utility of sonography both in the treatment of OD through percutaneous drilling and in follow-up. Conclusions: On the basis of the good results obtained in the case described here, it is thought that sonographically guided percutaneous drilling may be a good alternative to arthroscopic drilling in cases of early OD lesions without displacement of the fragment.
Metadata only
Selección y diagnóstico de mujeres de alto riesgo de cáncer de mama / Juan de Dios Berna Serna ; director José Luis Genovés García.
(Murcia : Universidad de Murcia, Facultad de Medicina,, 1987) Berná Serna, Juan De Dios
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Optimización de las dosis de radiación en la artrografía de hombro
(Elsevier, 2009-05-01) Campos, P.A.; Redondo, M.V.; Reus, M.; Martínez Martínez, Francisco; Berná Serna, Juan De Dios; Cirugía, Pediatría y Obstetricia y Ginecología
Objetivo: El objetivo de este estudio fue reducir la dosis de radiación recibida por los pacientes sometidos a una artrografía de hombro y en los que se utiliza como sistema de guiado una placa con coordenadas radiopacas situada sobre el área de interés. Material y métodos: La dosis a la entrada se obtuvo en 34 pacientes con edades comprendidas entre 15 y 75 años, media de 44 años. La dosis a órganos de riesgo y la dosis efectiva se estimaron mediante técnicas de Monte Carlo, donde los parámetros de entrada son: anatomía del paciente, geometría de la exploración y kerma en aire a la entrada del paciente sin retrodispersión. Las artrografías se realizaron en un equipo telemando y las imágenes se obtuvieron mediante adquisición digital sin fluoroscopia. Resultados: El espesor medio de los hombros estudiados fue 14,6±2,1 cm (9–20 cm). Las imágenes se obtuvieron con 80±10 kVp (60–85 kVp) y 6,5±3,5 mAs (1,4–17 mAs). El tiempo medio de irradiación para cada paciente fue 20±6 ms (6,9–47,9 ms). El kerma en aire calculado fue de 0,41±0,19 mGy y la dosis efectiva de 0,79±0,40 μ Sv. Conclusiones: La técnica descrita en este trabajo ha permitido reducir la dosis de radiación al paciente respecto a otros procedimientos descritos en la bibliografía y que el radiólogo que realiza la artrografía no se irradie durante el procedimiento.
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Sonographically guided percutaneous intralesional triamcinolone injection: a new treatment for mammillary fistulas. Preliminary results
(Wiley, 2012-04-01) Berná Mestre, Juan de Dios; Piñero, Antonio; Carrascosa, Maria C.; Berná Serna, Juan De Dios; Dermatología, Estomatología, Radiología y Medicina Física
We describe a new procedure, sonographically guided intralesional triamcinolone injection, for the treatment of mammillary fistulas. Six patients with mammillary fistulas were enrolled in this prospective study. Clinical improvement was rapid after the first triamcinolone injection. The initial response to treatment was assessed as complete in 4 cases, and the remaining 2 cases resolved successfully with additional injections. On the basis of the excellent results obtained in this study, it is thought that intralesional triamcinolone injection may be a good alternative to surgery.
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MR arthrography of the shoulder using an anterior approach: optimal injection site
(American Roentgen Ray Society, 2012-11-23) Redondo, María V.; Campos, Pedro A.; Reus, Manuel; Martínez Martínez, Francisco; Campos, Matilde; Domenech, Ernesto; Berná Serna, Juan De Dios; Cirugía, Pediatría y Obstetricia y Ginecología
OBJECTIVE. The purpose of our study was to optimize anterior MR arthrography of the shoulder by comparing three injection sites. MATERIALS AND METHODS. Seventy-eight patients were divided into three groups of 26 each, according to the injection site selected: the upper third of the medial part of the humeral head, the lower third of the medial part of the humeral head, or the area between the middle and lower thirds of the glenohumeral joint. A marker plate with radiopaque coordinates was used in performing the technique. Radiologist time and exposure time were recorded, and the intensity of the patient's pain was measured using a Visual Analogue Scale (VAS). Groups were compared using variance analysis and the least significant difference method. RESULTS. Shoulder arthrography was considered satisfactory for all three injection sites. Mean exposure time was 20.9 ± 7.8 (SD) milliseconds, and mean radiologist time was 6.4 ± 0.8 minutes. Mean pain intensity registered by the VAS was 1.7 ± 0.9, the lowest values tending to be those recorded by patients who received an injection in the upper third. Exposure and radiologist times were lower for these latter patients; differences between the upper third and the other two areas were statistically significant (p < 0.005). CONCLUSION. The optimal injection site for anterior MR arthrography of the shoulder is the upper third of the humeral head, a simple, rapid procedure that is well tolerated by patients and reduces the radiation dose administered.