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Biomedical subjects

A González-Quintela

Publications and source records attributed to A González-Quintela.

At least 19 recordsLinked to original sources
PubMed2005

Circadian variability of blood pressure in liver transplant recipients without antihypertensive therapy.

Hypertension is a frequent cardiovascular risk factor in liver transplant recipients. The usefulness of ambulatory blood pressure monitoring (ABPM) in these patients is unknown. This study was aimed at evaluating the circadian rhythms of blood pressure in liver allograft recipients. In 53 liver transplant patients blood pressure was measured with the Spacelabs device program. No patient received antihypertensive therapy for at least 15 days beforehand. Clinical blood pressure measurement showed 26 patients to be hypertensive. Of these, ABPM verified the diagnosis in 23. Overall, 72% of the patients were hypertensive, and 39.5% showed a nondipper pattern. Diastolic hypertension was more frequent than systolic hypertension. No differences were found in renal function, immunosuppressive therapy, or corticosteroids.

Adult↗
PubMed2005

Evaluation of the phadiatop test in the diagnosis of allergic sensitization in a general adult population.

BACKGROUND: Phadiatop is a commercially available qualitative serological test employed for screening of allergic sensitization in patients with suspected allergic diseases. AIM: The study evaluated the diagnostic accuracy of Phadiatop for the diagnosis of allergic sensitization in a general adult population. METHODS: A total of 469 subjects from the population of A-Estrada (Spain) were selected by age-stratified random sampling (age range, 18-92 years). Phadiatop test (Uni-CAP method) was performed in serum samples from 465 of these subjects. Skin prick tests to a panel of 13 relevant aeroallergens in the studied area (including mites, pollens, moulds, and animal dander) were employed as the reference diagnostic procedure. Subjects with at least a positive skin prick test (> or =4 mm, n= 120) were considered to have allergic sensitization. RESULTS: Phadiatop sensitivity was 70.8% (95% CI 61.7-78.6%), specificity 90.7% (95% CI 87.0-93.5%), positive predictive value 72.6% (95% CI 63.5-80.3%), negative predictive value 89.9% (95% CI 86.2-92.8%), global accuracy 85.6% (95% CI 82.0-88.6%), negative likelihood ratio 0.3 (95% CI 0.2-0.4), and positive likelihood ratio 7.6 (95% CI 5.4-10.8). A high proportion of false-positive Phadiatop cases showed (a) increased total serum IgE levels, (b) significant alcohol consumption, and (c) small-sized (below the diagnostic cut-off) wheal reactions on SPT. A high proportion of false-negative Phadiatop cases showed exclusive storage mite sensitization. Sensitivity and positive predictive value of Phadiatop were somewhat higher among individuals with a history of nasal or bronchial symptoms. CONCLUSIONS: Phadiatop is a valuable tool for the diagnosis of allergic sensitization in a general adult population. However, limitations of the test should be taken into account in similar surveys.

Adolescent↗
PubMed2004

Isoniazid-induced hyperacute liver failure in a young patient receiving carbamazepine.

A 16-year-old female under long-term carbamazepine and clobazam therapy developed fulminant liver failure after initiating therapy with isoniazid, rifampin, and pirazinamide for intestinal tuberculosis. Liver failure was hyperacute (with a minimal interval between jaundice and encephalopathy) and occurred very shortly (5 days) after the start of antituberculous therapy. The patient recovered completely with conservative measures. Later, she tolerated carbamazepine, clobazam, rifampin, and pirazinamide without problems, thus confirming that liver failure was isoniazid-induced. Drug interaction between isoniazid and carbamazepine could explain the atypical presentation of this case.

Journal Article↗
PubMed2004

Liver disease in heavy drinkers with and without alcohol withdrawal syndrome.

BACKGROUND: Withdrawal syndrome is a hallmark of alcohol dependence. The characteristics of alcohol consumption, closely related to dependence, could influence the development of alcoholic liver disease. The study aimed to investigate if patients with severe alcohol withdrawal syndrome have a peculiar profile of liver disease. METHODS: The study included 256 heavy drinkers (aged 19-75 years, 70.3% males) admitted to an Internal Medicine Department. Patients admitted for complications of liver disease were not included. Severe alcohol withdrawal syndrome (seizures, disordered perceptions, or delirium) developed in 150 patients (58.6%). Alcohol consumption (daily quantity, duration, and pattern [regular or irregular]) was assessed by questionnaire. Liver biopsy was performed in all cases. RESULTS: Patients with alcohol withdrawal syndrome showed a lower prevalence of liver cirrhosis and a higher prevalence of alcoholic hepatitis than patients without it. The negative association of alcohol withdrawal syndrome with liver cirrhosis persisted after we adjusted for sex, daily intake, duration, and pattern of alcohol consumption. Alcoholic hepatitis was independently associated with the irregular pattern of alcohol consumption, which was closely associated with severe alcohol withdrawal syndrome. CONCLUSIONS: The profile of liver injury is different in heavy drinkers who develop and who do not develop a severe alcohol withdrawal syndrome when admitted to the hospital.

Adult↗
PubMed2004

High prevalence of storage mite sensitization in a general adult population.

BACKGROUND AND AIM: Occupational and nonoccupational storage mite (SM) allergy has received considerable attention in recent years. The study aimed to evaluate both the prevalence and factors associated with sensitization to SMs in a general adult population from a warm and humid area where mites are the predominant allergens. PATIENTS AND METHODS: An age-stratified random sample of 720 subjects was drawn from the population older than 18 years of A-Estrada (Galicia, Spain). From 697 eligible subjects, 469 (67%, median age 54 years, range 18-92 years, 44% males, 75% of cases from a rural environment) agreed to participate. Skin prick tests to SMs (Lepidoglyphus destructor and Tyrophagus putrescentiae), house dust mite (Dermatophagoides pteronyssinus), pollens, moulds and animal danders were performed in all cases. Wheals >or= 4 mm were considered positive. Epidemiological data were assessed by questionnaire. A design-based analysis was performed and all calculations were weighted to give unbiased estimates. RESULTS: Tyrophagus putrescentiae and L. destructor were the leading causes of allergic sensitization throughout all ages. SM sensitization was found in 104 cases (weighted value 24.4%, 95% CI 20.6-28.2). SM sensitization was inversely associated with age. Multivariate analysis showed that SM sensitization was not significantly associated with sex, smoking, educational level, farming profession, rural environment, indoor humidity, presence of pets, livestock or grain storage facilities near home. CONCLUSIONS: SMs (T. putrescentiae and L. destructor) are major aeroallergens in adults in the region studied, even in subjects without occupational exposure.

Adolescent↗
PubMed2004

Abnormalities in liver enzyme levels during Salmonella enteritidis enterocolitis.

OBJECTIVE: To evaluate the prevalence, associated factors, and time-course changes of abnormal liver enzyme serum levels in adult patients with Salmonella enteritidis enterocolitis. METHODS: The clinical records of 104 patients (age range 15-86 years, 46.2% males) admitted to hospital because of S. enteritidis enterocolitis were reviewed. The prevalence of abnormal liver enzyme levels was evaluated, as well as its possible relationship to data of systemic inflammatory response, severe sepsis, and bacteremia. In addition, time-course changes in serum levels of liver enzymes were studied in 16 cases with available follow-up after hospital discharge. RESULTS: In patients without a pre-existing cause for liver enzyme abnormalities (n = 84), the prevalence of serum AST elevation was 23.0% (95% CI 15.4-34.5%), of serum ALT elevation was 17.9% (95% CI 0.6-20.0%), and of GGT elevation was 19.0% (95% CI 11.6-29.3%). The prevalence of abnormality for any of these enzymes (AST, ALT, or GGT) was 35.7% (95% CI 25.7-46.8%). The prevalence of altered serum alkaline phosphatase was lower. Alteration in liver enzyme serum levels was moderate in the majority of cases, and was found in association with the presence of fever. Serum enzyme levels decreased during the convalescence period after hospital discharge. CONCLUSIONS: Abnormalities in liver enzyme levels are frequent during severe enterocolitis due to S. enteritidis in adult patients. These abnormalities are moderate and self-limited.

Adolescent↗
PubMed2003

[A population study of the efficacy of pulsioxymetry in diagnosing obstructive sleep apnoea syndrome].

OBJECTIVES: To evaluate the use at home of night-time pulsioxymetry to diagnose obstructive sleep apnoea syndrome in the general population. DESIGN: Cros-sectional study of diagnostic tests. PARTICIPANTS: Random sample of 70 individuals chosen from a Health Centre´s appointment records. MAIN MEASUREMENTS: Anamnesis concerning sleep and respiratory disorders during sleep, anthropometric measurements, Epworth´s sleepiness scale, home night-time pulsioxymetry and polysomnography. RESULTS: Visual inspection by oxymetry gave 82% sensitivity (95% CI, 62-93) and 69% specificity (95% CI, 53-82) for the diagnosis of obstructive sleep apnoea syndrome. Other indices such as the time with oxygen saturation below 90% and the number of desaturations above 4% gave a sensitivity of 82% and 86% and specificity of 63% and 65%, respectively. All the cases of clinically significant obstructive apnoea were diagnosed by pulsioxymetry. CONCLUSIONS: Night-time pulsioxymetry is a useful test for general screening of obstructive sleep apnoea.

Humans↗
PubMed2003

Association of alcohol consumption with total serum immunoglobulin E levels and allergic sensitization in an adult population-based survey.

BACKGROUND: Chronic alcoholism is associated with increased total serum IgE levels. OBJECTIVE: The study aimed to investigate the relationship between alcohol intake and both total serum IgE levels and allergic sensitization in a general adult population. MATERIALS AND METHODS: A total of 720 subjects was randomly selected (stratified by age) from the population older than 18 years of A-Estrada (Spain) and invited to participate in the study. From 697 eligible subjects, 469 (67%, median age 54 years, range 18 to 92 years, 44% males, 75% of cases from a rural environment) agreed to participate. A battery of 13 skin prick tests to common aeroallergens was performed in all subjects. Cases with at least one positive test (n = 121, 26%) were considered to have allergic sensitization. The most frequent sensitisers were mites and pollens (24% and 10% of subjects, respectively). Total serum IgE was measured in 465 subjects (99%). Alcohol consumption was registered as the number of standard (approximately 10 g) drinking units habitually consumed per week. A total of 244 subjects (52%) were alcohol consumers (median intake, 14 units/week, range 1 to 147 units/week). Abstainers (n = 225, 48%) constituted the reference category. RESULTS: Alcohol consumption of more than 14 units/week was associated with an increase in serum IgE levels after adjusting for age, gender, allergic sensitization and smoking (P = 0.02). Alcohol consumption was not significantly associated with either overall allergic sensitization or mite sensitization after adjusting for age, gender and smoking. However, alcohol consumption of more than 14 units/week was associated with an increased prevalence of pollen sensitization (adjusted OR 3.15, 95% CI 1.19 to 8.34, P = 0.02). CONCLUSION: Alcohol consumption above a certain threshold is associated with an increase in total serum IgE levels. Alcohol consumption may also be associated with an increased prevalence of pollen sensitization.

Adolescent↗
PubMed2002

Influence of alcohol consumption on serum immunoglobulin E levels in atopic and nonatopic adults.

BACKGROUND: Total and specific serum immunoglobulin E (IgE) are routinely used as diagnostic tools in allergy clinics. Several studies have demonstrated an increase of total serum IgE concentrations in alcoholics, but the possible influence of lower quantities of ethanol intake on serum IgE values has not been fully evaluated. This study was aimed at analyzing the influence of alcohol intake on both total and specific serum IgE concentrations in patients studied in an allergy clinic. METHODS: A total of 460 patients were included in the study. According to skin-prick tests to common aeroallergens, 325 were classified as atopics and 135 as nonatopics. Most atopic patients (253; 78%) were allergic to mites. Alcohol consumption was recorded as the number of standard (10-g) drinking units regularly consumed per week. Two hundred subjects (43%) were abstainers, and 260 (57%) were regular consumers of a median of 30 g of alcohol per week. Total serum IgE was measured in all patients by latex-enhanced nephelometry. Serum-specific IgE was assayed by fluoroenzymeimmunoassay. RESULTS: Total serum IgE increased along with ethanol consumption. On multivariate analysis, regular alcohol consumption greater than 70 g per week was associated with increased total serum IgE levels, even when adjusting for age, sex, atopy, and smoking. Among house-dust mite-allergic patients, specific serum IgE values against the house dust mite Dermatophagoides pteronyssinus were higher in regular alcohol consumers than in abstainers. This difference was not observed among patients allergic to grass pollen (Lolium perenne). CONCLUSIONS: Alcohol consumption, even in moderate quantities, is associated with increased total and specific IgE concentrations in subjects studied in an allergy clinic. Alcohol intake should be taken into account in epidemiological studies of total serum IgE levels.

Adolescent↗
PubMed2001

[Epidermoid cyst: a rare cause of cystic liver disease].

We present the case of a 42-year-old male patient with a large hepatic cyst, simulating a hydatid cyst. Subtotal cystectomy was performed. Thirteen months after this procedure the patient relapsed and a second laparotomy and total cystectomy were performed. A histopathological diagnosis of epidermoid cyst of the liver was made. The differential diagnosis of epidermoid cysts of the liver is broad and definitive diagnosis is usually only obtained after pathological examination of the surgical specimen. For this reason, and because of the potential for neoplasia, complete resection of the hepatic lesion should be attempted.

Adult↗
PubMed2001

Comparison of montelukast versus budesonide in the treatment of exercise-induced bronchoconstriction.

BACKGROUND: Previous studies in which leukotriene-receptor antagonist and corticosteroids were used have suggested a possible role for these anti-inflammatory drugs in the prevention of exercise-induced bronchoconstriction, but no direct comparisons have been made. OBJECTIVE: A crossover study was undertaken to compare the ability of both montelukast and budesonide to protect patients from exercise-induced bronchoconstriction. METHODS: A total of 20 patients (median age, 17 years; range, 8 to 36 years), who had clinical exercise-induced bronchoconstriction for 1 year and decreased FEV1 of at least 20% after exercise on two occasions, were enrolled in this study. To compare the therapies in each patient, we administered, consecutively, 10 mg of montelukast once daily at bedtime for 3 days and, later, 400 microg of budesonide twice daily for 15 days, or vice versa, with a 15-day intervening washout period during which no patient received treatment. Exercise challenges were performed at baseline (no therapy) and after each treatment. The percentage of FEV1 declines at 2, 7, and 12 minutes after exercise and the area under the curve (summarizing the extent and modification of FEV1 decreases relative to time) were measured and compared. RESULTS: Both budesonide and montelukast significantly reduced the decrease in FEV1 (area under the curve) after exercise with respect to the baseline condition of no therapy (P = 0.0001). Overall, budesonide offered better protection (area under the curve) than did montelukast (P = 0.01), particularly in the short-term evaluation (2 minutes after exercise; P = 0.003); however, considerable individual variations in the responses to both budesonide and montelukast were observed. The degree of protection against decreases in FEV1 ranged from 0% to almost 100% for both treatments. In 16 of 20 patients, budesonide therapy offered better protection than did montelukast, and in the other 4 patients, montelukast showed better protection than did budesonide. No side effects of either montelukast or budesonide were detected during the study. CONCLUSIONS: Treatment with budesonide or montelukast prevents exercise-induced bronchoconstriction. Because substantial variation in the response may be present among patients, both drugs should be tested in each patient before long-term therapy is chosen.

Acetates↗
PubMed2001

Increased serum IgE in alcoholics: relationship with Th1/Th2 cytokine production by stimulated blood mononuclear cells.

BACKGROUND: Increased serum immunoglobulin (Ig) E values are frequently found in alcoholics. Cytokines produced by T-helper-2 (Th2) lymphocytes are required for IgE synthesis. Chronic alcoholism is associated with altered cytokine balance. This study analyzed the relationship between Th1 and Th2 cytokine production by stimulated peripheral blood mononuclear cells (PBMCs) and serum IgE levels, both in atopic and nonatopic alcoholics. METHODS: Twenty-five patients admitted to the hospital with alcohol withdrawal syndrome were included in the study. Five were classified as atopic and 20 as nonatopic by means of skin-prick tests. Interleukin-4 (IL-4), IL-10, IL-12, IL-13, and interferon gamma were measured in the supernatants of 48-hr cultures of PBMCs stimulated with phytohemagglutinin. Total serum IgE was measured by chemiluminescent enzyme immunoassay. Results were compared with those of 15 healthy controls (seven atopics and eight nonatopics). RESULTS: Total serum IgE concentrations were higher in alcoholics than in controls, in both atopic and nonatopic subjects. The ratio of IL-4 to interferon gamma production by phytohemagglutinin-stimulated PBMCs (as an approach to Th2/Th1 balance) was significantly lower in alcoholics than in healthy controls, both in the atopic and in the nonatopic group. No difference was observed regarding IL-10, IL-12, and IL-13 production between alcoholics and controls. No correlation was demonstrated between cytokine production and total serum IgE levels in any group. CONCLUSIONS: Increased total serum IgE is observed in alcoholics together with a paradoxically low ratio of Th2 to Th1 cytokine production by phytohemagglutinin-stimulated PBMCs. These findings are independent of the atopic status of patients.

Adult↗
PubMed2001

Cecal ligation and puncture as a model of sepsis in the rat: influence of the puncture size on mortality, bacteremia, endotoxemia and tumor necrosis factor alpha levels.

BACKGROUND: Cecal ligation and puncture is a widely used experimental model of sepsis. AIM OF THE STUDY: The present study was aimed to evaluate the influence of the size of the cecal puncture on mortality, bacteremia, endotoxemia and plasma TNF-alpha levels. MATERIALS AND METHODS: Female Sprague-Dawley rats underwent cecal ligation and puncture, divided into the following groups, defined by the diameter of the cecal puncture: 0.5-cm blade incision (n = 25), 13-gauge (n = 25), 16-gauge (n = 25), 18-gauge puncture (n = 25) and 4 punctures with a 22-gauge needle (n = 25). A sham operation was performed in another 25 rats. Three animals of each group were sacrificed 5 h after the procedure for blood cultures as well as determination of plasma endotoxin and TNF-alpha. The remaining animals were followed up for a week after cecal ligation and puncture for evaluation of mortality. RESULTS: Five hours after cecal ligation and puncture, bacteremia was present in all animals, independently of the puncture size. Endotoxemia and plasma TNF levels tended to increase along with the diameter of the cecal puncture. Mortality gradually increased with the puncture size, from 27% with a 22-gauge needle to 95% with the blade incision. CONCLUSIONS: The severity of sepsis obtained with cecal ligation and puncture in rats can be easily modulated varying the size of the puncture.

Animals↗