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Biomedical subjects

A Fuertes

Publications and source records attributed to A Fuertes.

At least 37 records · Page 2Linked to original sources
PubMed1995

Transplantation of kidneys from donors with hepatitis C antibody into recipients with pre-transplantation anti-HCV.

Hepatitis C virus (HCV) is transmitted by organ transplantation. Consequently, several organ procurement organizations have imposed a moratorium on use of organs from anti-HCV positive donors. Because of the inadequate supply of cadaver kidneys for transplantation, we adopted a policy to transplant kidneys from anti-HCV donors into anti-HCV positive recipients. During the period between March 1990 and December 1992, 24 anti-HCV positive dialysis patients received a kidney from anti-HCV positive donors (group I) and 40 anti-HCV positive patients received a kidney from anti-HCV negative donors (group II). We compared the prevalence of liver disease, anti-HCV, HCV RNA, graft and patient survival between groups. Pre-transplantation 17 of 24 (71%) patients in group I and 31 of 40 (79%) of patients in group II had serum HCV RNA. Post-transplantation follow-up was 26 +/- 8 months and 30 +/- 10 months in groups I and II, respectively. During follow-up, elevated ALT levels were present in 7 of 24 (29%) and 16 of 40 (40%) of patients in groups I and II, respectively (P > 0.05). Post-transplantation, all patients in both groups retained anti-HCV. The prevalence of HCV RNA post-transplantation was 22 of 23 (96%) patients in group I and 30 of 39 (77%) of patients in group II (P > 0.05). Graft and patient survival in group I (96% and 100%, respectively) were not significantly different from those in group II (93% and 98%, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

[A comparative randomized controlled study of the efficacy of interferon alfa-2b and interferon alfa-2a in the treatment of chronic hepatitis C].

Interferon (INF) is the treatment of choice in active chronic hepatitis C although the optimum therapeutic schedule remains undefined to date. One forty-eight patients with active chronic hepatitis C were included in a randomized controlled study to compare the therapeutic efficacy of 2 types of recombinant alpha IFN: alpha-2b IFN and alpha-2a IFN. Twelve patients were excluded from the study for different reasons. The groups were made up of 34 untreated patients (group I), 68 patients treated with 5 MU of alpha-2b IFN three times per week for 12 months (group II) and 32 patients with 6 MU of alpha-2a IFN three times per week for one year (group III). On finalization of the treatment 39 patients from group II (57%) and 20 (63%) from group III showed normal transaminases (p > 0.05) while this was not so in any patient from group I (p < 0.001). HCV infection of less than 5 years was significantly associated with complete biochemical response. During the post treatment follow up (16.2 +/- 11.1 months; range: 6-45 months) the transaminase levels reelevated in 26 (67%) responding patients from group II and in 12 (60%) patients from group III (p > 0.05). Therefore complete biochemical response was maintained in only 12 (19%) of the patients from group II and in 8 (25%) of the patients from group III (p > 0.05). Liver biopsy was carried out in the 3 post treatment months in 15 patients from group I, 29 from group II and 18 patients from group III with all the rebiopsied patients from groups II and III having demonstrated complete or partial response to IFN.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Clinical significance of hepatitis C virus (HCV) infection in liver transplant recipients. Role of serology and HCV RNA detection.

Hepatitis C virus (HCV) infection was studied in 60 liver transplant recipients. Antibodies to HCV were tested by both a second-generation ELISA test and a four-recombinant immunoblot assay (4-RIBA) just before the transplant and every three months thereafter. HCV RNA detection was performed by polymerase chain reaction (PCR) at least three times after the transplant in all the patients. Thirty-nine patients tested negative by ELISA before LT (group A), 14 patients tested positive by both serological tests (group B), and seven tested positive only by ELISA (group C). Posttransplant hepatitis was diagnosed in 11/14 in group B in comparison with 3/39 in group A (P < 0.001) and 1/7 in group C (P < 0.05). HCV RNA was detected in the sera of 14/14 patients in group B but in only 1/7 in group C and 6/39 in group A. Only 2/15 patients developed posttransplant hepatitis in the absence of HCV RNA detection. These data suggest that HCV is the major cause of hepatitis after LT. Patients HCV seropositive by RIBA test before the transplant formed a group of high-risk patients for developing viremia and hepatitis afterwards.

Adult↗
PubMed1993

Laminin fragment P1 is increased in the lower respiratory tract of patients with diffuse interstitial lung diseases.

Laminin is a 900,000-dalton extracellular matrix glycoprotein involved in a variety of functions, including cellular movement, growth, and differentiation. The aim of this work was to investigate the presence and biologic significance of this substance in the bronchoalveolar lavage fluid (BALF) of diffuse interstitial lung diseases (DILD). Levels of laminin fragment P1 (LFP) were measured by radioimmunoassay in BALF and sera from controls (n = 8) and patients with several types of DILD: sarcoidosis (n = 10), neoplastic pulmonary infiltration (n = 8), pulmonary fibrosis (n = 5), and hypersensitivity pneumonitis (n = 5). Furthermore, their relation to signs of alveolitis (cellular profiles and albumin concentration in BALF) and evidence of pulmonary fibroblast activation (BALF aminoterminal propeptide of type III procollagen) was examined. Laminin fragment P1 immunoreactivity was detectable in BALF, even in the control group, but patients with all types of DILD had higher concentrations than the control subjects. The serum levels of LFP were similar in all groups studied. Neutrophil and lymphocyte proportions were significantly higher in all DILD groups than in the control group. A positive correlation was seen between lymphocyte proportion and laminin fragment P1 in BALF. Moreover, in BALF a positive correlation was found between LFP and albumin and between LFP and the aminoterminal propeptide of type III procollagen. The BALF macrophage-associated laminin fragment P1 was significantly higher in the active sarcoidosis subgroup compared with the control group. Thus, laminin is a normal constituent of the epithelial lining fluid. The increase of laminin in BALF of patients with DILD suggests that laminin may contribute to their pathogenesis.

Adult↗
PubMed1992

[Prospective study of cytomegalovirus infection in liver transplant recipients].

BACKGROUND: Cytomegalovirus (CMV) infection is an important cause of morbidity and mortality in liver transplant recipients. The aim of this study was to determine the incidence, clinical characteristics, risk factors and response to treatment of CMV infection in liver transplant recipients. METHODS: Fifty-nine adult patients who underwent a liver transplant in our hospital were prospectively studied. Cell cultures were used to document CMV infection and disease. Ganciclovir treatment was only given to patients with documented CMV disease. RESULTS: Active infection was shown in 47 of 59 patients (80%), and symptomatic infection (disease) in 17 (29%). The most frequent clinical presentation was hepatitis (9 cases) followed by flu-like syndrome (6 cases) and pneumonitis (4 cases). The average time from transplant to the diagnosis of CMV disease was 36 days. The seronegative recipients of seropositive donors developed symptomatic infection more frequently (66%) than other patients (p < 0.05). As well as the CMV serologic status before transplantation, the use of anti-OKT3 antibodies was the only risk factor related to CMV disease (p < 0.01). The treatment with ganciclovir was successful in 17 of 19 symptomatic episodes. CONCLUSIONS: Active and symptomatic CMV infection in recipients of liver transplantation were very frequent in our study. The transplant from seropositive to seronegative and the use of anti-OKT3 antibodies increased the incidence of CMV disease. Ganciclovir appeared as a safe and, apparently, highly efficient drug.

Adult↗
PubMed1991

Characterization of HBV2-like infections in Spain.

Hepatitis B viral serum markers suggestive of infection by hepatitis B virus type 2 were found in 354 patients tested in the laboratory during a 2.5 year period of study. Confirmation of the HBsAg reactivity by neutralization and subtyping analysis and determination of serum HBV-DNA by molecular hybridization were carried out on selected samples from these patients. Clinical and epidemiological data were obtained from 234 patients and serological follow-up was done in 70 cases. The results obtained from the confirmatory tests and DNA assays indicated that HBsAg reactivities were specific, being frequently associated to low levels of HBV-DNA. The incidence rates obtained for HBV2 serological patterns among patients at different level of risk for HBV infection, as well as the finding of a high rate of coinfection with hepatitis A virus among those showing acute hepatitis, suggested that the HBV2 agent could be transmitted by the oral route. An hypothesis considering the so called HBV2 infections as resulting from infections by an HBV variant strain which has an improved ability for non-sexual, non-parenteral transmission is suggested. Specific recommendations for detection and confirmation of such cases in blood banks are also outlined.

Adolescent↗
PubMed1986

Brucellar arthritis in children and its successful treatment with trimethoprim-sulphamethoxazole (co-trimoxazole).

The clinical characteristics and the response to treatment with high doses of co-trimoxazole in 12 children with brucellar arthritis were analysed retrospectively. The children lived in an urban area and all but two had a history of unprocessed milk or cheese ingestion. Fever and oligoarthritis of the lower extremities were the most common clinical findings. Control of the disease was achieved by three months of treatment. Compliance with the medication was excellent, and no significant side effects occurred.

Adolescent↗