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Biomedical subjects

A Ríos

Publications and source records attributed to A Ríos.

At least 37 records · Page 2Linked to original sources

Acute lower gastrointestinal hemorrhage originating in the small intestine.

INTRODUCTION: Lower gastrointestinal hemorrhage (LGIH) is generally self-limiting, and the most frequent etiologies are located at colonic level. The objective here is to analyze the diagnostic and therapeutic handling of acute LGIH when its etiology was located in the small intestine. PATIENTS AND METHODS: Between 1975 and March 2002, 12 acute cases of LGIH originating in the small intestine were admitted to our service. All consulted the hospital with acute rectorrhage, requiring a transfusion of at least 3 units of concentrated red blood cells. The mean age was 54 +/- 21 years, 58% were women, and 83% had experienced previous episodes of LGIH. RESULTS: in eleven cases (92%) an urgent lower and upper endoscopy was performed without locating the source of bleeding. An arteriography was indicated in 7 patients (58%), which located the bleeding origin in 5 of them. In two cases a scintigraphy was performed, showing a Meckel's diverticulum in one patient and a normal image in another. All were operated on; in 8 cases (67%), surgery was urgent; in 9 cases, a tumor was found, and in three additional patients, a case of Meckel's diverticulum was found, with a resection being carried out for all lesions. Histology showed a leiomyoma in 7 cases, a Meckel's diverticulum in 3 cases, a leiomyoblastoma in 1, and an angioma in the remaining case. After a mean follow-up of 132 +/- 75 months, the leiomyoblastoma resulted in death, and there was a relapse in the case of angioma, which was successfully embolized with interventional radiology. CONCLUSIONS: Acute LGIH originating in the small intestine should be considered a possible etiology when digestive endoscopy does not locate the source of bleeding, with arteriography being a useful diagnostic technique for bleeding localization. Surgery is the definitive treatment--it confirms the etiology and rules out the presence of malignancy.

Acute Disease↗

Use of non-aqueous capillary electrophoresis for the quality control of commercial saffron samples.

A non-aqueous capillary electrophoresis (NACE) method for quantifying the seven crocin metabolites that are the major biologically active ingredients of saffron was developed. Separation is done by using a fused silica capillary filled with a 12.5 mM H3BO3/37.5 mM sodium tetraborate methanolic solution as background electrolyte. The results obtained were compared with the total index "safranal value", widely used as a quality measure of saffron products. The comparison revealed that the proposed NACE method provides useful information not obtained in the safranal value. Infact, samples with a similar safranal value can contain crocin metabolites in different concentrations and relative proportions. This new method is very useful for quality control in commercial saffron samples.

Carotenoids↗

Attitude toward deceased organ donation and transplantation among the workers in the surgical services in a hospital with a transplant program.

INTRODUCTION: There are data that suggest that the percentage of hospital workers not in favor of donation is relatively high, even in services that are directly related to transplantation. The objective was to analyze attitudes toward decreased organ donation in the surgical services. MATERIALS AND METHODS: A random sample was stratified by the surgical service and the job category (n = 263) in a third-level hospital with a transplant program assessed attitudes toward the donation of ones own organs after death using a questionnaire including psychosocial factors as validated in our geographic surroundings. Student t test and the chi-square test were used for data analysis. RESULTS: Favorable attitudes toward donation were observed in 68% (n = 178) as opposed to 32% with an attitude that was undecided or against the act (n = 85). The psychosocial variables that showed significant relationships with this attitude were age (most in favor are younger; P = .021); nonmedical surgical staff (50% against donation; P = .0001); resident physicians (94% in favor; P = .001); discussion and prior consideration of donation (P = .016); knowledge of the concept of brain death (an important factor in nonhealth staff; P = .010); attitude toward manipulation of the deceased (P = .011) and concerns about mutilation (P = .026); partner's opinion toward organ donation (P = .0001); and existence of frequent medical errors (P = .003). No significant differences were found, depending on whether the services were involved in a specific transplant program (P = .853). CONCLUSIONS: Favorable attitudes toward donation among the hospital staff on surgical services, including those who perform transplants, did not reach more than 70% and was determined by multiple psychosocial factors. Donation promotion activities are necessary for these services, given the importance that this group's negative attitude could have on the attitude of the general population.

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Attitude toward living related donation of patients on the waiting list for a deceased donor solid organ transplant.

INTRODUCTION: Spain is the country with the highest rate of donation from deceased individuals. However, given the deficit in organs, living donation is being encouraged. Our objective was to analyze attitudes toward living donation among patients on the waiting list for a transplant. MATERIALS AND METHODS: Patients on the waiting list for a kidney or liver transplant (n = 96; 46 kidney and 50 liver) in the last year had their attitudes toward living donation evaluated through a psychosocial survey performed in a direct interview with an independent health professional from the transplant unit and analyzed by Student t test and the chi-square test. RESULTS: Ninety-one percent were in favor of donating their organs when they die, 6% had doubts, and the remaining 3% were against it. Twenty percent would accept living donation from a family member (32% in liver vs 7% in kidney; P < .05), despite 89% of them accepting that there would be a risk to the family member. Twenty percent reported that a family member had suggested donating, but the patient was opposed. Finally, only 6% considered living donation to be their first choice, 42% did not consider this option. Up to 96% would donate an organ to a family member if they were requested to do so. CONCLUSION: Patients on the waiting list are not favorable to living related donation for themselves, although members of their family have proposed it to them. However, the liver patient is more prepared to accept it, possibly because that patient has no other alternative as do kidney patients have dialysis. Even so, they are favorable toward donating a living organ if a family member were to request one. In general, living donation is not being proposed to these patients as a real option, partly because of their doctors.

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Rural primary care centers as a source of information about organ donation.

INTRODUCTION: Primary care is an important way of promoting health in the community, and this includes organ donation. In rural areas, this way of promoting health acquires special importance. Our objective was to analyze attitudes toward organ donation among primary care workers in rural health centers to assess their importance in circulating information about donation. MATERIALS AND METHODS: A random sample, stratified according to job category among the primary care staff (n = 160), of workers in rural areas in our autonomous community (population < 10,000 inhabitants), evaluated attitudes toward donation using a questionnaire validated in our geographic area. To distribute the questionnaire it was necessary to contact the following in each health center: the coordinating physician, the nursing coordinator, and an administrative worker. RESULTS: Of those questioned, 78% (n = 124) were in favor of donation, as opposed to 22% (n = 36) who are against it or undecided. As for the job category, physicians and nurses showed a more favorable attitude than nonhealth workers (90% and 80% vs 61%; P = .000). The psychosocial variables that were related to such an attitude were knowledge of the concept of brain death (P = .013) and lack of fear of manipulation of the deceased person (P = .002). Regarding information about organ donation and transplantation, 54% (n = 86) reported having been provided favorable information, with up to a quarter of the physicians considering other programs to be of greater interest for primary care than organ donation and transplantation. CONCLUSION: Attitudes toward organ donation were favorable among a high percentage of primary care workers in rural centers; more than 50% have circulated favorable information on the subject. However, there is a high percentage with a negative or undecided attitude, especially among nonhealth workers, which should be reversed with promotional activities at the level of the health center.

Attitude to Health↗

Attitude survey of hospital workers in the surgical services toward living kidney donation.

INTRODUCTION: A living donor kidney is currently the most accepted kind of solid organ donation, given the low level of morbidity and mortality and the good results in the recipient. In Spain, its use is still scarce; even many health service workers are not in favor. Our objective was to analyze the attitudes toward living kidney donation in a surgical department. MATERIALS AND METHODS: A random sample was stratified according to surgical services and job category in a tertiary hospital with an solid organ transplant program. Attitudes toward living kidney donation were evaluated using a questionnaire on donation and transplantation, which evaluated various psychosocial variables. Student's t test and the Chi square test were used. RESULTS: Two hundred sixty-three respondents of mean age 40 +/- 10 years were analysed for attitudes toward living kidney donation. The level of acceptance was 87% (n = 229) versus 13% undecided or against the procedure (n = 34). No differences were observed according to job category. The variables that showed a relationship with the attitude were the partner's attitude toward donation (P = .049); the possible need for an organ oneself (P = .0001); and belief that medical errors occur (P = .001). The attitude toward cadaveric organ donation was not reflective of that toward living kidney donation (P = .241). CONCLUSIONS: A favorable attitude toward living kidney donation was high among hospital staff of the surgical department. Those for whom it was not favorable were influenced by personal factors such as partner's attitude and the possibility of needing a kidney in the future.

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Attitude of primary care nurses toward living kidney donation.

INTRODUCTION: Nursing is a fundamental service in caring for the health of the public. The opinion of nurses toward a certain type of donation may have a strong population impact. In this respect, living kidney donation is increasing in Spain; it is important to raise awareness at all levels. The objective here was to analyze the attitudes of primary care nursing personnel toward living kidney donation and to their determinants. MATERIALS AND METHODS: A random sample of primary care nurses stratified by geographical location (six health areas in our community), included 139 nurses from 32 health centres. Attitudes toward living donation were evaluated using a questionnaire with various psychosocial variables. For the distribution of the questionnaires, contact was made with the nursing coordinator in each centre. They were completed anonymously. The chi-squared test and Student's t test were applied. RESULTS: The attitudes toward living kidney donation were favorable in 93% of those questioned (n = 129), mainly when the donation is related (78%, n = 109). Only one nurse was against the idea of donating a kidney from a living person (1%); nine had doubts about this kind of donation (7%). Seventy-six percent (n = 106) have cared for patients awaiting a transplant; however, no relationship was found with attitude toward this type of donation (P = .209). Of all analyzed variables, there was only a significant relationship with concern about possible body mutilation (P < .0005) and partner's opinion about the matter (P < .0005). We wish to highlight that no relationship was found with attitudes toward cadaveric organ donation (P = .712). CONCLUSIONS: Attitudes of primary care nursing personnel toward living kidney donation were favorable, especially if it was related donation.

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Prevention of hyperacute rejection in a model of orthotopic liver xenotransplantation from pig to baboon using polytransgenic pig livers (CD55, CD59, and H-transferase).

INTRODUCTION: The search for alternative sources for transplant organs leads us to the search for animals as an inexhaustible source of organs. The objective of this study was to analyze whether livers from polytransgenic pigs expressing the human complement regulatory proteins CD55 (hDAF), CD59, and alfa alpha1,2-fucosyltransferase (H-transferase), protected against hyperacute rejection after orthotopic liver xenotransplantation to a baboon and also to study pig liver function in a nonhuman primate. MATERIALS AND METHODS: Nine liver transplants from pig to baboon were divided into two groups: a control group (n = 4) of genetically unmodified pigs and an experimental group (n = 5) of pigs transgenic for CD55, CD59, and H-transferase as donors. All the donating piglets obtained through hysterectomy were maintained in specific pathogen-free conditions. The selection of transgenic pig donors followed demonstration of transgene expression using monoclonal antibodies (antiCD55, antiCD59) and immunohistological studies on liver biopsies. RESULTS: All animals in the control group developed hyperacute rejection with survival rates less than 16 hours without function of transplanted livers. In the experimental group none of the animals suffered hyperacute rejection. Survival in this group was between 13 and 24 hours. The livers were functional, producing bile and maintaining above 35% prothrombin activity. Only in one case was there primary dysfunction of the xenograft. CONCLUSION: Polytransgenic livers for complement regulatory proteins prevent hyperacute rejection when xenotransplanted into a baboon.

Acute Disease↗

Attitude toward xenotransplantation in kidney and liver patients on the transplant waiting list.

INTRODUCTION: The deficit in transplant organs is encouraging research into stem cells and xenotransplantation. However, many studies have shown that using animals for human transplantation could be rejected by society. The objective here was to analyze the attitude of patients on the waiting list toward a possible transplant of an organ of animal origin. MATERIALS AND METHODS: Patients on the waiting list for kidney and liver transplants including last year (n = 96) underwent a direct interview by an independent health professional from the transplant unit. Using a psychosocial survey, an evaluation was made of attitudes toward donation of organs of animal origin and its various options. Student t test and the chi-square test were used for analysis. RESULTS: If results from xenotransplantation could be superimposed onto those of human transplantation, 71% would accept such an organ. In the case of the kidney, 83% would accept, 4% would not, and 13% have doubts; as opposed to 60%, 12%, and 28%, respectively, of liver cases (P < .05). Supposing that the results were worse than in human organs, only 26% would accept an animal organ. Thus, for kidney, 33% would accept it, 48% would not, and 20% would have doubts; and for liver, it would be 20%, 50%, and 30%, respectively. In a life-threatening situation 98% would accept an animal organ as a bridge of hope in the wait for a human organ. In addition, if the organ functioned correctly, 98% would keep the animal organ, thus avoiding an intervention to substitute a human organ. CONCLUSION: If xenotransplantation became a clinical reality, acceptance of an animal organ by patients on the waiting list would be low, especially if the results could not be superimposed onto human ones. Only its use as a bridge until the arrival of a human organ would increase its acceptance.

Animals↗

Attitude toward xenotransplantation among residents.

INTRODUCTION: The deficit in transplant organs has made it necessary to search for alternatives, among them research into xenotransplantation. However, the use of animal organs may cause rejection in society and among health professionals. The objective was to analyze the acceptance of this therapy among Residents, given that they would be the professionals most involved in its application if such a therapy proves to be useful. MATERIALS AND METHODS: A random sample stratified by the services of the Residents in a third-level hospital with an organ transplant program and accredited for teaching at undergraduate and postgraduate levels (n = 171). The attitude toward xenotransplantation was evaluated using a questionnaire that analyzes different pychosocial variables that may influence such attitude.(5) RESULTS: The sample consisted of 171 residents (mean age 28 +/- 4 years; 56% women). Attitudes toward xenotransplantation, whether the results were similar to those obtained with human organs, were positive in 81% (n = 138) of cases, with 16% (n = 27) having doubts and 3% (n = 6) being against. The attitude was more favorable among residents in favor of cadaveric donation (83% vs 57%; P < .05) and of living donation either of the kidney (90% vs 55%; P < .001) or of the liver (88% vs 56%; P < .001), and among those who consider that they might need a transplant at a given point in the future (88% vs 73%; P < .05). CONCLUSION: Residents have a positive attitude toward the application of a possible xenotransplantation in safe conditions similar to those that currently exist in human organ donation. Such a favorable attitude was greatly influenced by a positive attitude toward human organ donation, in cadaveric as well as in living donation, and when considering oneself to be a possible candidate for a transplant.

Adult↗

Acceptance level of living liver donation among primary care nursing personnel.

INTRODUCTION: Living liver donation is not exempt from risks to the donor, although it is currently ethically accepted. It is important to examine the level of acceptance among the different health levels toward this therapeutic option, in order to design promotion and awareness-raising activities. The objective herein was to analyze the attitudes and the factors that condition them among nursing personnel in Primary Care (PC) toward living liver donation. MATERIALS AND METHODS: This random survey was stratified by geographical location (6 health areas in our community) among PC nurses, obtaining a total of 139 nurses from 34 health centers. Attitudes toward living liver donation were evaluated using a questionnaire on donation which included different psychosocial variables. For the distribution of the questionnaire, the nursing coordinator of each centers was contacted to distribute questionnaires which were completed anonymously. The chi-square test and Student t test were applied. RESULTS: Attitudes toward living liver donation were favorable in 89% of those questioned (n = 124) if it is related donation; 3% (n = 4) were against donating a living hemiliver and 8% (n = 11) had doubts. It is important that up to 76% (n = 106) have cared for transplant patients or patients awaiting transplant, however, no relationship was observed with attitude to this type of donation (P = .489). Of all the analyzed variables, there was only a significant relationship between attitudes and concern about possible body mutilation (P < .0005), and partners attitudes toward this matter (P < .0005). It is noteworthy that no relationship was found with attitudes toward cadaveric donation (P = .062). CONCLUSION: Despite the risk of morbidity and mortality in the donor, the attitude of the PC nursing personnel toward living liver donation was favorable, especially if the donation is related.

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Attitudes toward living liver donation among hospital personnel in services not related to transplantation.

INTRODUCTION: The deficiency in livers and waiting list mortality have encouraged more living liver donation, although it is not exempt from morbidity and mortality. The enthusiasm of transplant teams for this kind of donation is increasing; however, the attitudes toward it are not so clear among other health professionals. Our objective was to analyze the attitudes toward living liver donation among hospital professionals in services without habitual relations with transplantation. MATERIALS AND METHODS: A random sample was stratified for service not related to transplantation and job category, in a third level hospital with a transplant program. Attitudes toward living liver donation were evaluated using a psychosocial questionnaire on living donation. RESULTS: A total of 419 respondents were analyzed (doctors, n = 184; nurses, n = 119; assistant nurses, n = 80; and non-health workers, n = 36), with a mean age of 37 +/- 10 years. The attitude toward living liver donation was favorable in 82% (n = 344). Among the other respondents, half (9%; n = 38) were against and the other half (9%; n = 37) were undecided. No significant differences were found among the doctors, nurses, assistants, and non-health workers. However, when the three categories were grouped in opposition to the non-health workers, there was greater indecision among non-health workers than the others (19% vs 8%; P = .0001). On analyzing the variables that determine this attitude we observed the following: having commented upon and previously discussed donation (P = .016); believing in the possibility of needing an organ oneself (P = .0001); and being in favor of living kidney donation (P = .0001) and cadaveric donation (P = .004). CONCLUSIONS: Hospital personnel in services not related to transplantation favor living liver donation, especially if it is a related donation, despite its greater risk, except among non-health workers. However, it is important to conduct informative and awareness-raising campaigns in hospitals if such a type of transplantation is to be encouraged.

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Pathology findings in a model of auxiliary liver transplantation with portal vein arterialization in pigs.

OBJECTIVE: To determine the histological findings and temporal evolution that occur in auxiliary liver grafts as a consequence of arterialization of the portal vein (PVA). MATERIALS AND METHODS: We evaluated 10 auxiliary heterotopic liver transplants with arterialization of the PVA. The histological study was performed using an optical microscope to process liver samples with staining using hematoxylin and eosin. A biopsy of native liver tissue was used as a control. RESULTS: Two animals were excluded from the study, one due to ischemic necrosis of the graft and one that died 4 hours after transplant. All of the remaining eight animals underwent a histological study at 1 day, 7 days, and 14 days. The most significant histological findings were: (1) dilation of portal areas and sinusoids, which were detected at 24 hours and persisted; (2) thickening of the interlobular septum, which was observed after day 7 and progressively increased to day 14; (3) bile duct hyperplasia detected at the seventh day. CONCLUSIONS: The consistent, early findings in a pig liver with PVA included vascular dilation of the portal area and the sinusoids, with bile duct hyperplasia extending progressively and the thickening of interlobular connective tissue septa with a generalized perilobular connective tissue reaction, which did not seem to alter the internal structure of the lobule, which showed histologically normal hepatocytes. The fibrous reaction may be the first stage in chronic hepatopathy. Further long-term studies are required in this model.

Animals↗

Attitudes toward xenotransplantation among nonhealth service workers in a hospital with a preclinical xenotransplantation program.

INTRODUCTION: Our hypothesis was that nonhealth workers (NHW) in our hospital should have a more favorable opinion toward xenotransplantation than the general population, given that this group is in closer contact with a preclinical xenotransplantation program. Therefore, our objective was to determine the attitude of NHW in a hospital with a preclinical liver xenotransplantation program and to determine the factors that influenced this attitude. MATERIALS AND METHODS: A random sample of 276 subjects in nonhealth services was used. For the distribution of the questionnaire, we contacted the head of each of the services and explained the project. They became responsible for the distribution and collection of the questionnaires in randomly selected work shifts. A random sample of 250 individuals from our community was used as a control group. RESULTS: As for animal organ donation for humans, if the results could be superimposed on those achieved by human donors, 63% would be in favor, 30% undecided, and the remaining 7% against. The attitude toward xenotransplantation was more favorable in the control group (74% versus 63%, P < .05). On analyzing the variables that influence attitudes toward xenotransplantation, we found that there is no significant relationship to the classical psychosocial variables (P > .05). However, there is a relationship to prior attitudes toward different types of human organ donation and the possibility of needing a transplant oneself. CONCLUSIONS: The attitudes toward xenotransplantation among NHW are not as favorable as in the general population.

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