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Biomedical subjects

A Segarra

Publications and source records attributed to A Segarra.

32 records · Page 2Linked to original sources
PubMed1994

[Isotopic renogram after captopril administration: clinical experience in the assessment of the hypertensive patient].

BACKGROUND: Isotopic renogram allows renal function to be estimated in both kidneys independently. The glomerular filtrate in ischemic kidneys is largely dependent on the tone of the efferent glomerular arteriolae and therefore on the concentration of circulating angiotensin II. METHODS: In 42 patients with severe high blood pressure in whom renal angiographic study was carried out for suspicion of vasculo-renal hypertension, an isotopic renogram using 99m Tc-DTPA as a tracer was performed in basal conditions and following the administration of 50 mg of oral captopril. RESULTS: In 21 patients both the angiographic examination and the post-captopril renogram were normal. In 16 patients in whom uni or bilateral stenosis higher than 50% of the lumen of renal artery was observed on angiographic examination, the post-captopril renogram showed changes. In 5 patients the angiography was normal while the renogram showed evaluable changes. No false negatives were observed in the post-captopril renogram, however the basal renogram was not demonstrative in 6 patients with stenosis of the renal artery. Sensitivity of the test was thus 100% and specificity 80%. The positive predictive value was 76% and the negative predictive value 100%. CONCLUSIONS: The post-captopril renogram may be a useful test in the functional study of renal behaviour in patients with vasculo-renal hypertension.

Adolescent↗
PubMed1994

[The percutaneous dissolution treatment of gallstones. Our initial experience].

OBJECTIVE: To describe our initial experience in direct contact dissolution of cholesterol gallstones with methyl-tert-butyl ether, a non surgical approach for high risk patients. PATIENTS: Twenty symptomatic patients were preselected. They all had radiolucent stones in functioning gallbladders. Patients rejected elective surgery or were considered to be of high risk for anesthesia. Computerized tomography scan was performed to evaluate stone calcium content and liver-gallbladder anatomy. In selected patients, contact stone dissolution was carried out after transhepatic gallbladder catheterization. RESULTS: Ten patients were excluded due to poor gallbladder contact to the liver (two patients) or stone density greater than 70 Hounsfield Units. Percutaneous transhepatic positioning of the catheter into the gallbladder was achieved in seven patients. Stone dissolution was complete in five patients and partial in one. Mean perfusion time was 6.15 hours (3.45-7.5); however, mean hospitalization stay was 7 days (4-10) mainly due to inexperienced management coordination. While on treatment, all patients experienced nausea, burning or abdominal discomfort that were easily controlled. Complications were related to catheter placement (intraperitoneal biliary leakage, external fistula) and in five patients to the dissolution procedure (severe abdominal pain, biliary colic, cholecystopancreatitis). Complications were all handled with non surgical treatment. CONCLUSIONS: Percutaneous gallstone dissolution with methyl-tert-butyl ether is a rapid and efficacious procedure that can, nevertheless, induce relevant secondary effects and complications.

Adult↗
PubMed1993

Carboplatin, methotrexate, vinblastine and epirubicin (Carbo-MVE) for transitional cell bladder carcinoma.

BACKGROUND: MVAC is considered the most effective chemotherapy regimen for transitional cell bladder carcinoma. However, due to its significant toxic effects we substituted carboplatin for cisplatin and epirubicin for adriamycin in an attempt to produce the same response with less toxicity. PATIENTS AND METHODS: Twenty-seven patients with invasive transitional cell bladder carcinoma received Carbo-MVE: carboplatin (300 mgr/m2 d2), methotrexate (30 mgr/m2 d1, 15, 22), vinblastine (3 mgr/m2 d2, 15, 22) and epirubicin (30 mgr/m2 d2) every 4 weeks. RESULTS: There were 2 complete clinical responses (8.4%), 5 partial clinical responses (20.8%), 8 stabilizations (33.3%) and 9 progressions (37.5%). The overall clinical response rate was 29.2% (11%-47.4%, 95% CI), but 2 partial clinical remissions were not pathologically confirmed; were they to be considered as non-responses the response rate would fall even lower (20.8%). Toxicity was moderately severe, with 77.8% developing WHO grade III-IV granulocytopenia, 22.2% grade III-IV thrombocytopenia and 59.3% grade II-III vomiting. There were no toxic deaths nor any renal toxicity. CONCLUSIONS: Our results suggest that Carbo-MVE is less active and at least as hematotoxic as multiagent CDDP-based regimens.

Aged↗
PubMed1993

Successful treatment of haemodialysis catheter-related sepsis without catheter removal.

Thirty-six Permcath double-lumen catheters implanted in 36 chronic renal failure patients for haemodialysis treatment were prospectively studied. When catheter-related sepsis was suspected a quantitative blood culture was obtained simultaneously from the catheter and from a peripheral vein. If bacterial colonies in the catheter blood specimen were fourfold greater than identical bacterial colonies in the peripheral blood specimen, the test was considered indicative of catheter sepsis and an empirical antibiotic regimen was begun while the central line remained in situ. Eleven patients suffered 13 episodes of catheter-related sepsis. Staphylococcus epidermidis and Pseudomonas aeruginosa accounted for 77% of the strains isolated. All episodes were successfully treated with vancomycin or ciprofloxacin and yielded negative results on follow-up quantitative blood cultures. Fever subsided within the first 48 h of therapy and no complications occurred. None of these patients required catheter removal for cure of the catheter-related sepsis.

Adult↗
PubMed1989

[Acute interstitial secondary to tricuspid endocarditis caused by Staphylococcus aureus].

The kidney diseases in patients with bacterial endocarditis and intravenous drug addicts (IVDA) tend to be of glomerular origin. Interstitial nephritis has been related to drug toxicity and only occasionally has it been described in other associations. We describe a 27-year-old patient IVDA with tricuspid endocarditis caused by S. Aureus whose first manifestations was acute renal failure. The renal biopsy showed an interstitial nephritis. It was treated with antibiotic and hemodialysis, obtaining the cure and normal levels of plasmatic creatinine.

Acute Disease↗
PubMed1989

[Computerized tomography findings in annular pancreas in an adult].

We present a case of annular pancreas in an adult female studied by computerized tomography. CT demonstrated an enlarged pancreatic head in the center of which was visualized the contrast-filled duodenal lumen. We consider these findings to be sufficiently characteristic of annular pancreas to permit differential diagnosis with neoplastic processes of the pancreatic head without having to resort to more invasive diagnostic methods like endoscopic retrograde cholangiography.

Female↗
PubMed1984

Cerebral computed tomography in maple syrup urine disease.

Maple syrup urine disease (MSUD) is an inherited metabolic disorder due to decreased decarboxylation of branched chain keto acids triggering an accumulation of leucine, isoleucine, and valine. We describe two infants with biochemically confirmed MSUD in whom computed tomography (CT) revealed cerebral edema. In one of these cases repeat CT 40 days after institution of appropriate therapy revealed that the edema had disappeared and the ventricles had enlarged.

Brain Edema↗