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A Rodríguez Pérez

Publications and source records attributed to A Rodríguez Pérez.

At least 19 recordsLinked to original sources
PubMed2005

[Xanthogranulomatous pyelonephritis in childhood. A case report].

Xanthogranulomatous pyelonephritis is an uncommon chronic inflammatory renal disorder. Most cases have been described in middle aged women and it is extremely rare in children. We report a case of a 4 year old girl who suffered from recurrent urinary tract infection and antibiotic therapy resistance. She had low growth-rate and palpable left renal mass on examination and was confirmed by radiological findings. We performed left kidney partial resection and then histological examination showed focal xanthogranulomatous pyelonephritis. The focal form of the disease may respond to antibiotic treatment although usually an enucleation or partial resection must be performed. In conclusion xanthogranulomatous pyelonephritis should be considered in the differential diagnosis of a renal mass and recurrent urinary tract infection in childhood.

Child, Preschool↗
PubMed2005

[Routine preoperative screening of asymptomatic patients: beliefs and attitudes of anesthesiologists in the Canary Islands, Spain].

OBJECTIVES: To identify factors that explain anesthesiologists' inappropriate use of preoperative tests in asymptomatic patients scheduled for elective surgery. MATERIAL AND METHODS: A validated questionnaire was sent to anesthesiologists at university hospitals in the Canary Islands. Information about preoperative testing patterns and reasons for selecting tests was gathered. RESULTS: The questionnaire was self-administered by 66 anesthesiologists (68% of the total). Scientific knowledge was not the reason why most respondents ordered preoperative tests in asymptomatic individuals. That was the opinion of 95% of anesthesiologists for chest x-rays, 82% for electrocardiograms, and 68% for laboratory tests. Clinical history and a medical examination gave sufficient information for selecting patients in need of specific tests in the opinion of 77.19% of the respondents. Half did not agree that routine electrocardiograms and laboratory tests should be abandoned. The justification for these tests was coverage of medical malpractice liability for 68.42%. Most considered that the need to order preoperative tests in asymptomatic patients increased after age 40. CONCLUSIONS: Although anesthesiologists admit that their request for preoperative tests in asymptomatic individuals is not supported by scientific evidence, the quest for safety and legal protection from the consequences of potential adverse consequences of providing anesthesia affects the selection of preoperative tests for asymptomatic patients.

Adolescent↗
PubMed2005

[Thoracoscopy with continuous positive airway pressure and collapse of only the operated lobe].

We report a case of diagnostic thoracoscopy of a right lobe in a patient with left upper lobe atelectasis due to invasion by a bronchial tumor. We anticipated difficulty in maintaining the desired oxygenation while using the conventional strategy of collapsing the whole operated lung and ventilating only the opposite one. The solution was to apply continuous positive airway pressure to 2 right lobes while only collapsing the lobe to be biopsied.

Biopsy↗
PubMed2003

[Pseudo-obstruction chronic disease, lymphoid hyperplasia of the gastrointestinal tract and intestinal endometriosis].

Nodular lymphoid hyperplasia of the gastrointestinal tract associated to endometriosis is an uncommon cause of chronic pseudo-obstruction and malabsortion. The case of a 32-year-old woman who suffered from this syndrome for one a half years is described. Diagnosis was achieved by laparotomy, which disclosed swelling and inflammation of the 30 cm terminal yeyunal portion. Removal of the involved intestine and side-to-side anastomosis were performed. The pathological findings were: follicular lymphoid hyperplasia with mucosal ulcers an fissures inflammatory pseudo-polyps, chronic deep enteritis and areas of endometriosis. A favourable outcome followed surgery.

Adult↗
PubMed2001

[Value of post-miction residue after urethrocervicopexy. Prospective study].

OBJECTIVE: To demonstrate that a high post-micturitional residue after a colposuspension is not a success predictive factor in the incontinence surgery. METHODS: We designed two identical groups of work, with the only difference of a high post-micturitional residue in one of them after the surgery (< 100 cc), and we evaluated the surgical results, with a follow-up of one year. We considered fails the presence of losses related with stress. RESULTS: There were no significative differences in the number of the deliveries, age, weight, length or body mass index in both groups. There were significative differences in the permanence of the urethral catheter and residue of urine, p < 0.001. There were no differences in the number of success in both groups. CONCLUSION: A high post-micturitional residue after colposuspension is not an influent factor in the final result of surgery.

Adult↗
PubMed2001

[Urethrocervicopexy in aged women. Prospective study].

OBJECTIVES: [corrected] To demonstrate that Burch colposuspension gives a higher index of fails in over sixty years women affected of stress incontinence than in women under sixty years of age. METHODS: We established two groups of follow-up, each of them included twenty women affected of stress urine incontinence and surgical treatment indication. The only difference between both groups was the age of the patients, with a limit established in sixty years. We have evaluated the results of surgical intervention one year after it. The binomial parameters are compared with x2 test; the continuous parameters with the t-Student test for independent parameters. RESULTS: We did not find statistical significative differences with number of deliveries, body mass index, previous pelvic surgery, perineal rehabilitation, or the importance of the incontinence, between both groups of women. We found statistical significative difference in the novo micturition urgency or an increase in a previous urgency (p < 0.1) in women over sixty years. We did not find statistical significative differences in the number of successes and fails in both groups. CONCLUSION: The age is not a risk factor of failing of Burch colposuspension, but it is a risk factor of the appearance or increase of micturition urgency.

Age Factors↗
PubMed2001

[Atypical manifestations of Whipple's disease].

We report 2 new cases of Whipple's disease (WD) with especial characteristics. In one case, an asymptomatic leukocytosis was the first manifestation, and after therapy the patient developed a gastric adenocarcinoma. In the second, the clinic suspect we led to try antibiotic treatment in absent of histological manifestations. The clinical, analytical and histological characteristics of both patients are described. We propose that WD should be listed in the differential diagnosis of unknown leukocytosis. Moreover, we indicate the possibility to try empirical antibiotic therapy in long-term cases without histological confirmation. Finally, we suggest a possible role of WD in the development of cancer.

Humans↗
PubMed2001

TNF-238A promoter polymorphism contributes to susceptibility to ankylosing spondylitis in HLA-B27 negative patients.

OBJECTIVE: To investigate the relative contribution of MHC loci in their susceptibility to primary ankylosing spondylitis (AS) in HLA-B27 negative patients and to compare the clinical features and genetic factors with those of HLA-B27 positive AS. METHODS: DNA from patients with B27 negative primary AS (n = 28), B27 positive primary AS (n = 77), and matched healthy controls (B27-, n = 100; B27+, n = 70) were analyzed to investigate whether HLA genes determine the disease susceptibility, or whether other closely linked loci might play a role in disease development. HLA typing was carried out by serology and PCR/SSP (HLA-B, -DR), MICA-TM polymorphism in the transmembrane region by radioactive PCR, and tumor necrosis factor-alpha (TNF-alpha) promoter polymorphism at positions -238 and -308 by PCR-RFLP. RESULTS: Subtle clinical differences were found for primary AS, the B27 negative patients being less frequently complicated by acute anterior uveitis and more associated with peripheral arthritis than B27 positive. Differences were found in the distribution of TNF-alpha -238 genotypes among patients with primary AS (B27- vs B27+). The TNF-alpha -238(A) polymorphism was present in 50% of the B27 negative patients carrying the -238 G/A and A/A genotypes and was significantly increased compared with B27 positive AS (odds ratio 4.3) and with the B27 negative control group (OR 5.9). The TNF-alpha genotypes were equally prevalent in B27 positive AS and healthy matched B27 positive controls. No significant HLA and MICA typing differences were found between the populations under study. CONCLUSION: Our results indicate that the polymorphism variation in the TNF-alpha promoter -238.2(A) influences disease susceptibility in B27 negative primary AS but had no effect in our B27 positive AS population.

Adult↗
PubMed2000

[Role of ribavirin in the treatment of chronic hepatitis B].

AIM: To evaluate the safety and efficacy of 1,200 mg/day of ribavirin for 6 months in the treatment of chronic hepatitis B. MATERIALS AND METHODS: An open study was carried out with 25 patients with chronic hepatitis B who had previously received placebo (first phase) as part of a randomized, double blind study and who remained HBeAg and HBV DNA positive. In the second phase they received oral ribavirin (1,200 mg/day) for 24 weeks and the results of the first phase were compared with those of the second. All the patients had a recent histological diagnosis and were anti-HCV and anti-HIV negative. In both phases clinical and laboratory evaluations were carried out at weeks, 0, 4, 8, 12, 16, 24, 32, 40 and 48 which included blood tests, liver function tests and serological markers of HBV, and HBV DNA when HBeAg became negative. Liver biopsy was performed at the beginning of the first phase, 6 months later and at the end of the second phase. RESULTS: Mean values of alanine aminotransferase (ALT) showed a clear downward trend and were reduced by 50% at the end of the study while during the first phase these values were similar to basal values (range 32.3-45.5 IU). In the second phase, seroconversion of HBeAg was 56.0% (p = 0.00001) and HBV DNA was negative in 36%. The number of patients who showed improvement in Knodell's index was 86.7% in the second phase vs. 13.3% in the first phase (p = 0.00001). The drug was well tolerated and the only significant adverse reactions were a reduction in hemoglobin levels greater than 10% of the basal value in 84% of the patients, gastric acidity in 40% and fatigue in 32%. CONCLUSIONS: Ribavirin therapy at a dose of 1,200 mg/day for 24 weeks was well tolerated and efficacious in returning serum ALT levels to normal, in the seroconversion of HBeAg and negativization of HBV DNA as well as in reducing liver necrosis and inflammation. This study confirms that ribavirin may be considered a therapeutic option in the treatment of chronic hepatitis B.

Alanine Transaminase↗
PubMed1998

[Silent axial arthropathy in inflammatory bowel disease. Clinical, radiological and genetic characteristics].

OBJECTIVES: To evaluate the prevalence, clinical and radiological characteristics, association with HLA B27 in a subgroup of patients with inflammatory bowel disease (IBD) and subclinical sacroileitis. The sensitivity of the diagnostic criteria for spondyloarthropathy in this group of patients is evaluated. MATERIALS AND METHODS: All patients with inflammatory bowel disease attending an outpatient gastroenterology unit from January 1994 to June 1994 were recruited. A total of 62 patients with IBD and without clinical evidence of axial involvement were included in the study. The demographic, clinical, and radiological characteristics were collected. The radiological examination included PA and lateral views for the dorso-lumbar, and three views (Ferguson, right and left oblique views) for the sacroiliac joints. Films were interpreted by three independent readers. The HLA B27 allele distribution was analyzed in the 62 patients and in 80 healthy controls. The modified New York criteria, Amor criteria, and European Spondyloarthropathy Study Group criteria were evaluated. Patients were prospectively followed for two years with the same initial protocol. The statistical management of data was performed with the information program SPSS/PC. RESULTS: Fifteen cases of silent sacroileitis were detected, and most of them were grade 2 unilateral sacroileitis. There was no correlation between sacroileitis and IBP type, extradigestive symptoms, disease duration, sex, or peripheral arthritis. The frequency of HLA B27 in the sacroileitis group was 20% (p < 0.05). During the two-year follow-up period none of these cases has changed from diagnostic category. The sensitivity of diagnostic the criteria for spondyloarthropathy was low in these patients (40%-53%). CONCLUSIONS: A high frequency of asymptomatic sacroileitis in patients with IBD was detected. We propose the term Silent Axial Arthropathy to define this category of patients and, as with other authors, we consider this is a third form of rheumatic syndrome in IBD, different from the classical forms of peripheral arthritis and ankylosing spondylitis.

Adult↗