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A González Quintela

Publications and source records attributed to A González Quintela.

At least 19 recordsLinked to original sources
PubMed2004

[De novo hepatitis B with anti-HBc negative in a liver transplant recipient [corrected]].

De novo hepatitis B was diagnosed in a 47-year-old man 15 months after liver transplantation for end-stage alcoholic cirrhosis. Serum antibodies to hepatitis B core antigen (anti-HBc) were negative, and remained undetectable over 20 months of follow-up. The possible causes of negative serum anti-HBc despite of active hepatitis B virus infection are reviewed. Immunosuppression may underlie this phenomenon in similar cases.

Antibody Formation↗
PubMed2004

[Tuberculous peritonitis: a Third World's disease?].

Tuberculous peritonitis has a high morbidity and mortality. The clinical outcome of tuberculous peritonitis depends on an early diagnosis and treatment. We review five cases of tuberculous peritonitis diagnosed in a short stay medical unit over a one-year period. All patients were successfully treated with antituberculous drugs. The clinical management of this disease is described and current views regarding the value of computed tomography and other diagnostic techniques are discussed.

Adult↗
PubMed2003

[Complications and yield of percutaneous liver biopsy with ultrasonographic marking].

OBJECTIVES: To describe the complications and the diagnostic yield of percutaneous liver biopsies performed under ultrasonographic control in an Internal Medicine department. PATIENTS AND METHODS: A total of 750 percutaneous liver biopsies were performed at the Internal Medicine department of our institution during the 1995-2001 time period. The Menghini technique was employed previous ultrasonographic marking of the puncture site was performed by the same physicians who performed the biopsy. Major and minor complications as well as the diagnostic yield (obtention of diagnostic hepatic tissue) of the technique were recorded. RESULTS: No deaths occurred in our series. Two patients (0.3%) had major complications presenting as liver subcapsular hematoma with hemoperitoneum which resolved with conservative measures. One of them was a male patient with acute leukemia and the other was a woman on antiaggregant therapy. Eight patients (1.1%) had minor complications (vasovagal syncope), all of them young males. In three cases no adequate material for diagnosis was obtained (technique yield 99.6%). CONCLUSIONS: In our series, percutaneous liver biopsy with ultrasonographic marking is a diagnostic technique associated with a low rate of severe complications and with a high diagnostic yield. The use of ultrasonographic marking by the same physicians performed the biopsy does not involve a longer time or increased cost of the technique, provides more safety in the procedure and has a low morbidity rate. This procedure could be used on a routine basis for all percutaneous liver biopsies.

Adolescent↗
PubMed2003

[Late-onset Wilsońs disease].

A 58-year old male with a past history of psychiatric disorders was studied for a persistent serum transaminase increase. Low serum ceruloplasmin level (lower than 3 mg/dL), increased urinary copper excretion, and increased liver tissue copper concentration (1050 mcg/g dry weight) confirmed the diagnosis of Wilsońs disease. Slit lamp examination did not show Kayser-Fleischer rings. D-penicilamin therapy was followed by serum transaminase normalization. Similar late-onset cases of Wilsońs disease are exceptional, but confirm the clinical heterogeneity of the disease.

Chelating Agents↗
PubMed2002

[Mutations in the HFE gene (C282Y, H63D, S65C) in alcoholic patients with finding of iron overload].

INTRODUCTION: The pathogenesis of iron overload in alcoholic individuals is not fully elucidated. The frequency of mutations in hereditary hemochromatosis (HFE) is high in this population. Heterozygotes show data of iron overload similar to those in alcoholic individuals. OBJECTIVE: To analyze whether iron excess among alcoholic individuals is associated with mutations in C282Y, H63D or S65C in the HFE gene. Patients and methods. Thirty-two active alcoholic individuals (29 males and 3 females, age range 30-67 years) with data of iron overload (increased serum ferritin with or without saturation of increased transferrin) were studied. In all individuals, mutations C282Y, H63D and S65C were investigated. From 16 cases, liver histology was available. Data on iron overload were compared between patients with and without mutations. RESULTS: Twenty-two patients (68.8%) did not show any mutation, one (3.1%) was heterozygous for C282Y, three (9.4%) were homozygous for H63D, four (12.5%) were heterozygous for H63D, and two patients (6.3%) were heterozygous for C282Y/H63D. None of the patients was homozygous for C282Y or presented mutation in S65C. Transferrin saturation, serum ferritin and liver iron index were similar among with and without mutations. Three patients (9.3%) were diagnosed of hemochromatosis. One of them was homozygous for H63D, other patient was heterozygous for the combined C282Y/H63D, and in the remaining patient none of the mutations was found. CONCLUSIONS: In our setting, iron overload among alcoholic individuals seems to be independent of the presence of mutations C282Y, H63D and S65C in the HFE gene.

Adult↗
PubMed2002

An update on infective endocarditis of dental origin.

OBJECTIVES: The aim of this study was to analyse the prevalence of dental treatment and oral infections related to the development of infective endocarditis (IE). METHODS: A retrospective study of 103 cases of IE diagnosed from 1997 to 1999 was conducted in Galicia, Spain. RESULTS: According to the Duke's endocarditis criteria (1994), 87 cases (84.5%) were considered definite IE. A presumed oral portal of entry was recorded in 12 patients (13.7%). Oral infections were held responsible in six cases while the remaining six had received dental treatment in the previous three months (three tooth extractions, one scaling, one cleaning, one fillings). In eight cases of IE (66.6%) typical oral pathogenic microflora was identified, with Streptococcus viridans being the most frequent. In four patients no previous cardiac disease was recorded. CONCLUSIONS: These results suggest that prevalence and characteristics of IE cases of dental origin did not change significantly in the last decades. The need for increased oral hygiene and improved dental care should be emphasized on preventing IE of dental origin. Continued education of physicians and dentists on the importance of the knowledge of current prophylactic protocols should also be considered.

Adolescent↗
PubMed2002

[Value of touch in the diagnosis of fever and of paleness in the diagnosis of anemia. Observational study in adults].

UNLABELLED: Estimation of fever by touch and of pallor as a sign of anemia are common practices during physical examination. The diagnostic value of these procedures has been extensively studied in children, but there are fewer studies in adults. OBJECTIVE: To evaluate the diagnostic value of physician's estimation of fever and anemia by touch and pallor, respectively. PATIENTS AND METHODS: The study included 600 patients (mean age 66 years, range 14-94 years, 58% males) admitted to a hospital (n = 300) or seen at its Emergency Department (n = 300). Two physicians independently estimated the presence of fever by touch, as well as the presence of anemia by pallor (in the skin, nail or conjunctiva). Axillary temperature and peripheral blood hemoglobin were employed as standards for comparison. RESULTS: Specificity of touch was higher than 90%, both for the diagnosis of axillary temperatures > or = 37.2 degrees C and > or = 38 degrees C, with a lower sensitivity. Interobserver concordance was fair (Kappa index, 0.47). Negative predictive value of touch was also high (99%) for the observed prevalence of fever (5%), with a very much lower positive predictive value. Similarly, specificity of pallor was high, particularly for hemoglobin values lower than 10 g/dL, with a substantially lower sensitivity. The best diagnostic values were obtained with conjunctival pallor. The Kappa index of concordance for the various types of pallor (skin, nail or conjunctiva) ranged between 0.39 and 0.44. Negative predictive value of pallor was high (98%) for the observed prevalence (9%) of significant anemia (hemoglobin < 10 g/dL), with a lower positive predictive value. CONCLUSIONS: In adult patients of a hospital, physi-cian's estimation of fever by touch and anemia by pallor have a relatively low diagnostic value. Nevertheless, the estimation that the patient is afebrile or not pale make very improbable the presence of fever and significant anemia, respectively.

Adolescent↗