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Biomedical subjects

A Gascón

Publications and source records attributed to A Gascón.

At least 19 recordsLinked to original sources

[Huesca and Teruel survey on hemodialysis management].

A cross sectional study was performed in order to evaluate the treatment conditions and medical outcomes among 131 prevalent hemodialysis patients (57% males; mean age 66 +/- 12 years) in Huesca and Teruel. Data were collected at 5 hemodialysis units in Huesca and Teruel. Diabetes mellitus, at 30 percent, was the most common cause of renal insufficiency. The mean (+/- SD) urea-reduction ratio (URR) was 66.0 +/- 8.8%. We observed that 56.5% of the population reached an URR higher than 65%. The duration of dialysis session was 220 +/- 24 minutes, with a rate of blood flow 297 +/- 47 ml/min. 36% of patients used high-flux membranes. The patterns of vascular access were: 69% arteriovenous fistula, 5% synthetic graft and 26% catheter. Eighty nine percent of patients were treated with erythropoietin. The mean dose of erythropoietin was 109 +/- 62 UI/Kg weight/week. Thirty nine percent of patients had haemoglobin below 11.0 g/dl (mean 11.2 +/- 1.4 g/dl). Ferritin levels were below 100 ng/ml in 24% of the patients and 25% showed a transferrin saturation index below 20%. Fifty percent of patients were receiving vitamin D. Serum calcium 9.3 +/- 0.8 mg/dl; phosphorous 5.5 +/- 1.5 mg/dl; calcium-phosphorous product 51.5 +/- 14.3 mg/dl; PTHi 433 +/- 459 pg/ml; and aluminium 26.8 +/- 14.5 mcg/l were the mean of main biochemical markers of mineral metabolism. Sixty eight percent of patients had phosphorous levels below 6.0 mg/dl. Thirty seven percent of patients had aluminium levels lower than 20 mcg/l. The mean serum albumin was 3.4 +/- 0.4 g/dl. Forty five percent of patients had albumin below 3.5 g/dl.

Adult↗

[Study of immutable variables determining rHuEPO dose requirements on hemodialysis patients].

Patients receiving recombinant human erythropoietin (rHuEPO) therapy show wide variability in their responsiveness to the drug. Variables that affect rHuEPO dose requirements can be broadly divided into modificable and immutable characteristics. Most of the scientific research on rHuEPO hyporesponsiveness has focused on modificable variables (iron status, dialysis adequacy), while immutable variables such as gender, etiology of chronic renal failure (CRF) and age have been insufficiently explored. A cross sectional study was performed in order to evaluate if immutable patient characteristics determine rHuEPO dose requirements among 215 patients (52% males; mean age 66 +/- 14 years) on hemodialysis (HD) for more than twelve months. Data were collected at 10 hemodialysis units in Aragon. Patients were divided into three groups according to their gender, their cause of CRF (diabetic nephropathy, vascular nephropathy, tubulointerstitial nephropathy and primary glomerulonephritis) and their age (younger than 60 years, from 60 to 75 years, older than 75 years). Despite a similar dose of rHuEPO, women had lower mean hemoglobin (11.1 +/- 1.5 versus 11.6 +/- 1.7 g/dl; p = 0.0258) than men. The greater hemoglobin in men than women may be attributed to greater serum albumin in men (3.5 +/- 0.3 versus 3.7 +/- 0.3 mg/dl; p = 0.0001). Requirements of rHuEPO were higher in the patients with etiology of primary glomerulonephritis compared with those with the other etiologies, even those with diabetic nephropathy (p = 0.0374). The rHuE-PO doses required to obtain similar hemoglobin levels were higher in patients younger than 60 years (p = 0.0249). We conclude that women, patients with primary glomerulonephritis as cause of CRF, and patients younger than 60 years showed the highest requirements of rHuEPO doses.

Aged↗

Alfuzosin-induced hepatotoxicity.

Drug-induced hepatic injury is a potential complication of virtually all drugs because the liver is central to the metabolic disposition of almost all drugs, although precise mechanisms often are unknown. We report a case of severe acute mixed hepatitis (cholestatic and hepatocellular), probably induced by alfuzosin. This event has not been reported previously (MEDLINE 1990, March 1999). Viral causes, autoimmune hepatitis and biliary tree obstruction were excluded. After discontinuation of the drug, liver function test results returned to normal.

Acute Disease↗

Nandrolone decanoate is a good alternative for the treatment of anemia in elderly male patients on hemodialysis.

OBJECTIVE: To assess the efficiency of nandrolone decanoate (ND) in the control of anemia in elderly male patients on hemodialysis (HD), and to determine its influence on nutritional parameters. DESIGN: A prospective 6-month study with randomization of patients on recombinant human erythropoietin (rHuEPO) therapy into two groups. Group A: rHuEPO was stopped before starting treatment with ND. Group E: rHuEPO was continued. SETTING: Renal unit, tertiary-care center. PATIENTS: 14 male patients in Group A and 19 patients, 12 males and 7 females, in Group E. INTERVENTIONS: In Group A rHuEPO was stopped and ND 200 mg/I.M. weekly was given over six months. RESULTS: The increase in hemoglobin and hematocrit levels was progressive with ND, and significant differences (p < 0.003) were evident after six months (9.6 +/- 1.0 vs 11.0 +/- 1.4 and 28.9 +/- 4.7 vs 33.0 +/- 4.7, respectively), which remained unmodified in Group E. Group A showed a significant increase in serum creatinine, total protein, transferrin and anthropometric parameters. These parameters remained stable and even presented a tendency to decrease in Group E. There was a significant rise in the concentration of triglycerides and a significant decrease in both HDL-cholesterol and apolipoprotein A-1 in Group A. However, lipoprotein (a) decreased significantly. No significant changes were detected in Group E. CONCLUSIONS: The use of ND would allow us an acceptable treatment of anemia as well as a better nutritional condition in elderly male patients on dialysis.

Aged↗