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Biomedical subjects

A Oliveras

Publications and source records attributed to A Oliveras.

13 recordsLinked to original sources

Ambulatory blood pressure monitoring in renal transplant patients: modifiable parameters after active antihypertensive treatment.

BACKGROUND: Hypertension (HT) accounts for nearly 60% to 80% of renal transplant patients (RT). It is one of the most important risk factors for cardiovascular diseases and may cause chronic graft dysfunction. Therefore, it is important to accurately detect and treat HT. We aimed to evaluate the changes in ambulatory blood pressure monitoring (ABPM) parameters among hypertensive RT after active treatment compared with baseline values. METHODS: Thirty seven RT (25 men, 12 women, aged 49.4 +/- 11.2 year) diagnosed with mild to moderate HT underwent 24-hour ABPM after a 4-week washout period (W0). For the 23 RT with confirmed HT of a second 24-hour ABPM was recorded after 4 weeks of treatment with doxazosin GITS (-4 mg once daily in the morning), a new formulation of an alpha1-receptor inhibitor (W4). Nondippers were considered when mean blood pressure (BP) showed a < or = 10% reduction during sleep. Statistical analyses included Saphiro-Wilks test, Student t test, and ANOVA. RESULTS: After active treatment systolic, diastolic, and mean BP (SBP, DBP, MBP) significantly decreased during diurnal and 24 hours but not the nocturnal period. No significant change was observed for heart rate nor for pulse pressure during any period. The prevalence dippers increased from 0% to 17% after treatment. After placebo administration 8 among 37 RT with HT diagnosed according to casual BP remained hypertensive at nighttime (but not at daytime) according to 24-hour ABPM. CONCLUSIONS: Diurnal and 24-hour periods of ABPM showed significant changes in SBP, DBP, and MBP after active treatment with doxazosin GITS. No significant BP changes were observed in the nocturnal period or in dipper status. Further studies using ABPM must be undertaken to determine the optimal dosage and time of administration of antihypertensive drugs in RT.

Antihypertensive Agents↗

Efficacy and safety of doxazosin GITS in hypertensive renal transplant patients: comparison of 8 and 4 mg.

BACKGROUND: Hypertension (HT), a prevalent complication in renal transplant patient (RT), must be accurately treated because cardiovascular disease is the leading cause of death and of chronic graft dysfunction. Sympathetic activity may contribute to HT in RT, yielding the rationale to suspect that doxazosin, an alpha1-adrenergic receptor inhibitor, may lower blood pressure (BP). The aim of this study was to evaluate the efficacy and safety of doxazosin GITS (4 and 8 mg) in RT. METHODS: Twenty-three hypertensive RT received doxazosin 4 mg once daily for 4 weeks (W4) followed by a 4-week washout (W0) and 17/23 treated with doxazosin 8 mg for 4 more weeks (W8) due to persistent HT. All patients underwent 24-hour ambulatory blood pressure monitoring (ABPM) after W0, W4, and W8. Laboratory tests were performed, adverse events recorded, and prostatic symptomatology examined. Statistical analysis included Saphiro-Wilks, Student t, ANOVA, Wilcoxon, or Friedman tests. RESULTS: The systolic, diastolic, and mean BP were significantly lowered at W4 in awake (P<.001) and 24 hour period (P<.005) but not sleep recordings. Doxazosin 8 mg had no significant additional effect to lower BP at any period. Normotension was reached in 13% and 21.7% of patients at W4 and W8, respectively. Palpitations were the only reported adverse event after treatment (incidence similar to placebo). There was no significant change in the laboratory values. CONCLUSIONS: Doxazosin (-4 mg) effectively decreased BP in awake and 24-hour periods without a significant improvement during sleep. A double dose of the drug added little benefit. Optimal BP was reached by an insufficient number of patients. Doxazosin proved to have a good tolerance and safe profile. This results suggest that doxazosin should be considered a good add-on treatment to other antihypertensive drugs in RT.

Adrenergic alpha-Antagonists↗

99mTc-labelled red blood cell scintigraphy for localization of gastrointestinal bleeding in chronic renal failure.

Angiodysplasia (AD) may be the source of bleeding in patients with gastrointestinal hemorrhage, with special occurrence in the elderly population and in patients with chronic renal failure (CRF). Although several techniques have been tested for its diagnosis, the gold standard is not well defined yet. We analyze the usefulness of 99mTc-labelled red blood cell (99mTc RBC) scintigraphy in the localization of bleeding from AD lesions in a cohort of 21 patients. Other investigative methods include fibrocolonoscopy examination, angiography, or diagnostic laparotomy. Group A (AD and CRF): 11 patients. Group B (AD without CRF): 10 patients. 99mTc RBC scintigraphy showed 88.9% sensitivity and specificity in group A, while in group B it had 100% sensitivity and specificity. Arteriography showed 100% sensitivity and specificity. On the contrary, fibrocolonoscopy had a very low sensitivity (30%). Our results suggest that 99mTc RBC scintigraphy may be the preferred diagnostic tool for AD, especially in patients with CRF, in whom arteriography may accelerate the decline of renal function.

Aged↗

[Thoracic actinomycosis].

BACKGROUND: Thoracic actinomycosis is an rare disease in our medium. This fact, together with the variability of its forms of presentation and the difficulty in isolating its etiologic agent, make its diagnosis, particularly difficult. METHODS: A series of 8 cases diagnosed in the years 1988, 1989 and 1990 in two centers (Hospital de Bellvitge-Prínceps d'Espanya and Hospital de l'Esperança) is described with evaluation of the clinical and analytical data and the therapy applied. RESULTS: Species were only identified in 3 cases with Actinomyces israelii in two and Actinomyces odontolyticus in the third. The proven association with Mycobacterium tuberculosis, the presence of distant septic metastasis and eosinophilic pleuritis as forms of presentation are of note. Medical treatment was penicillin or derivatives in all the cases except one which was treated with diagnostic/therapeutic segmentectomy. CONCLUSIONS: It is concluded that when any subacute involvement of the thoracic and/or pleuropulmonary wall specific cultures should be carried out to discard eventual thoracic actinomycosis.

Actinomyces↗