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A Fuertes

Publications and source records attributed to A Fuertes.

42 records · Page 3Linked to original sources
PubMed1976

Measured intelligence in offspring of oral and nonoral contraceptive users.

A study has been made of measures of intelligence of 210 children (5 to 8 years of age) born to mothers who used oral and nonoral contraceptives pregestationally. Ninety-six of these children were born to mothers who used oral contraceptives, and one hundred and fourteen were born to mothers who used vaginal contraceptive methods. The intelligence of the children was measured in the form of the full-scale I.Q. score by the Wechsler Intelligence Scale for Children (WISC) adapted and normalized for Puerto Rico by the Puerto Rico Department of Education. A three-factor analysis of variance was performed on the data collected for comparison of the two groups. It was observed that there was no significant difference between the average I.Q. scores of children born to mothers using oral contraceptives and those born to the mothers using nonoral contraceptives. The average I.Q. in children of the oral contraceptive group was 85.04 and that in children of the nonoral contraceptive group was 85.54. Distributions for both groups were also found to be similar. No significant differences between means were observed for sex, age, and interacitons with the exception of the age and sex interaction, where, again, no specific, meaningful trend could be established. The average I.Q. in the sample fell very close to the center of the "normal" range of the WISC, Puerto Rican adaptation. The results of the study do not offer any evidence as to the effect of the use of oral contraceptives on the intelligence measure (by the WISC) of the offspring born to mothers using them pregestationally. The children under study, on an average, are of "normal" intelligence as measured by the Puerto Rican intelligence standards.

Adult↗
PubMedDate not supplied

Twelve-month interferon-alpha therapy induces a similar sustained response in anti-HBe-positive and HBeAg-positive chronic hepatitis B patients.

BACKGROUND/AIMS: We compared the response to interferon-alpha 2a in 35 patients with antibody to HBeAg (anti-HBe) and 20 patients with HBeAg in serum, and histological features of chronic hepatitis B. METHODOLOGY: Patients were treated with 4.5-6 MU of interferon-alpha 2a, three times a week for 12 months, and followed for 30.8 +/- 13.5 additional months. RESULTS: All of them had elevated serum levels of aminotransferases and positive test for hepatitis B virus-DNA in serum. Patients with anti-HBe-positive chronic hepatitis were older and had higher serum aminotransferase levels than HBeAg-positive patients, but no differences were seen between both groups with respect to sex, history of acute hepatitis, mode of transmission of the infection or histological appearance before interferon therapy. Serum levels of alanine transaminase became normal and hepatitis B virus-DNA undetectable by PCR at the end of therapy in 25 (71%) of anti-HBe-positive patients and in 10 (50%) of HBeAg-positive patients (P > 0.05). Although 10 (29%) of the anti-HBe-positive and none of the HBeAg-positive patients relapsed, no significant difference was seen in the rate of sustained response (43% vs. 50%, respectively). The histological improvement was similar in both groups. CONCLUSIONS: The results of this study indicated that biochemical, virological and histological response to 12-month interferon-alpha 2a therapy was similar in patients with anti-HBe antibody than in patients with the classical HBeAg-positive of chronic hepatitis B.

Adolescent↗
PubMedDate not supplied

Liver transplantation and hepatitis C virus. Results in a Spanish center since 1989.

BACKGROUND/AIMS: Hepatitis C-related liver disease is the main indication for liver transplantation in many centers. Viral RNA remains after transplantation in almost 100% of the patients, and more recent reports show a graft hepatitis rate of about 90%. The progression of this hepatitis seems to be quicker than in the nontransplant setting. METHODOLOGY: From June 1989 to October 2000, 197 adult patients had 213 for HCV-related liver disease at our institution. Basal immunosuppression consisted of a triple therapy with cyclosporine, azathioprine and steroids, or dual therapy with tacrolimus and steroids. None of the patients was treated with antivirals after liver transplantation. RESULTS: Pure HCV-related cirrhosis was the indication for liver transplantation in 114 patients, another 14 with hepatocellular carcinoma, 8 associated metabolic diseases, 43 high alcohol intake, 4 hepatitis B, 5 cholestatic diseases, and 3 other diseases. Six patients out of the 197 transplanted in this period were already grafted before this time, and had their first retransplantation of the liver after 1989 (their first liver transplantation was done when HCV was not known). Sixteen additional retransplantation procedures were done in the period considered. Hepatitis was diagnosed in 84.3% of the grafts biopsied later than 90 days after liver transplantation (118/140), and in 92.9% if it was done after one year (92/99). Cirrhosis was diagnosed in 21 grafts at a mean time of 1004.7 days, 21.2% of the grafts biopsied after 1 year and 28.6% after 2 years. Nine grafts in 8 patients were diagnosed as fibrosing cholestatic hepatitis. Patient actuarial survival was 80.9%, 69.7%, 67.5% and 50.6% at 1, 3, 5 and 10 years. Liver failure and hepatoma recurrence were the cause of death in 42.4% of the patients. Actuarial graft survival was 75.2%, 64.9%, 63.5% and 48.6% at 1, 3, 5 and 10 years, and was significantly affected by Child stage (B vs. C, P = 0.004). When compared to 228 non-HCV- infected patients with chronic parenchymatous disease, these had an almost significantly better patient survival (P = 0.0577), but a nonsignificant difference in graft survival. Graft loss related to liver causes was 17.6% in HCV+ patients 14.6% in HCV- patients. Liver causes of death were 14.0% in HCV+ patients and 4.8% in HCV-patients (P = 0.002). CONCLUSIONS: HCV infected liver transplantation recipients present very often graft hepatitis, which may progress to advanced stages in a quite short interval. Mid-term patient and graft survival is comparable to those of non-HCV recipients, but causes of death related directly to liver disease are more common in HCV+. This makes one think that long-term prognosis (more than 10 or 15 years) will be worse in HCV patients.

Actuarial Analysis↗
PubMedDate not supplied

[Use of DNA sequence hybridization with specific oligonucleotide probes to identify hepatitis C virus genotypes].

BACKGROUND: Recent development of an assay based on the hybridization of the amplification product obtained by polymerase chain reaction (PCR) of the RNA of hepatitis C virus (HCV) with specific probes for each viral genotype ("reverse-hybridization"), has permitted to have a rapid, simple and reproductible technique to identify the different genotypes of HCV. The identification of HCV genotypes seems to be important given their different pathogenic capacity and response to interferon therapy. METHODS: We prospectively studied 221 patients with HCV infection defined by the detection of viral RNA in serum by "nested-PCR". HCV genotype was determined by "reverse-hybridization" using specific oligonucleotide-probes for each genotype corresponding to the 5, UTR. RESULTS: HCV 1b genotype was predominant in 221 patients studied (180/221, 81%), followed by 1a (10%) and by 3 and 4 (4% respectively). Two patients presented mixed infection (1a/1b). No case of infection by genotypes 2 and 5 was found. The predominance of 1b genotype was more evident in adults than in children (83 vs 62%) (p < 0.05). CONCLUSIONS: HCV 1b is the predominant genotype among our patients with hepatic disease induced by HCV. The reverse-hybridization assay is a simple and rapid technique that permit the identification of the most important genotypes of hepatitis C virus.

Adult↗
PubMedDate not supplied

Hepatitis B vaccination results in 140 liver transplant recipients.

BACKGROUND/AIMS: Human autologous liver transplantation is possible due to an adequate suppression of the body's immune response. This also causes a higher hepatitis infection rate, making hepatitis prevention very important. MATERIALS AND METHODS: We describe our experience with hepatitis B virus vaccination in 140 adult liver transplant recipients, transplanted from 1986 to 1994 with more than one year of follow-up. Excluded were those who had hepatitis B surface antigens or antibodies to those antigens before the transplant. The vaccination schedule was 0-1-2 months with a double dose of recombinant vaccine. RESULTS: The total response rate (surface antigen antibodies > 10 U) was 40% (56/140); the rate was 47.7% in men and 26% in women. At the end of the study, only 17.1% (24/140) of the patients had antibodies > 10 U. The response rate was higher in patients with antibodies to hepatitis B core antigen (66.6%) than in those lacking antibodies (31.7%), and more long lasting (42.4% vs 11.2%). The response rate in 116 patients with booster doses was 12.9%. Six correctly vaccinated patients (4.28%) acquired new hepatitis B virus infections after the operation. CONCLUSIONS: The total response rate in these patients is much lower than in the general population, and there is a rapid decline of titers, probably due to immunosuppression. The role of booster doses in these patients should be clarified.

Adolescent↗