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Biomedical subjects

A Torras

Publications and source records attributed to A Torras.

At least 73 records · Page 4Linked to original sources
PubMed1986

Cellular infiltrate in renal graft rejection: T lymphocyte subsets detected by monoclonal antibodies.

We have examined the interstitial cellular infiltrate using monoclonal antibodies against T cells (Cris 1), helper/inducer T cells (OKT4) and suppressor/cytotoxic T cells (OKT8) by indirect immunofluorescence in renal biopsies taken from 14 transplanted patients during clinical episodes suggestive of acute (n = 9), chronic (n = 2) and no rejection (n = 3). Infiltrating T cells and T cell subsets were found to be significantly increased during all types of rejection (n = 11) as compared to no rejection (n = 3). Two types of biopsies could be distinguished according to the predominance of T cell subsets. In some biopsies (n = 6), OKT8+ cells were significantly more numerous that OKT4+ cells. In the remaining biopsies (n = 5), OKT4+ cells were more common that OKT8+ cells, the OKT4/OKT8 ratio being significantly higher. No association was observed between HLA mismatch and predominating T cell subset, neither for type nor outcome of graft rejection. Our results suggest that the OKT4+ cells may play a more important role than previously reported in renal graft rejection.

Adolescent↗
PubMed1986

[Effectiveness of rectal metromidazole in acute infantile appendicitis].

Thirty two consecutive children who underwent surgery for suspected acute appendicitis, were treated with prophylactic metronidazole suppositories. A serum sample was taken at surgery to determine the serum concentration of the drug. After a preoperative dose of 15-20 mg/kg the minimal bactericidal concentration was achieved in almost all cases at the time of anesthetic induction. This drug showed an optimal biodisponibility when used rectally and no side-effects was noted. Neither a wound-infection, nor a wound-sepsis was reported and a satisfactory outcome was registered. We conclude that rectal dosing with metronidazole is effective for prophylactic wound infection in acute appendicitis.

Administration, Rectal↗
PubMed1985

Renal involvement in a syndrome of vasculitis complicating HBsAg negative cirrhosis of the liver.

Six HBsAg negative patients with cirrhosis of the liver (CL) presented with recurrent bouts of palpable purpura in the legs due to small vessel leucocytoclastic vasculitis. In addition, all patients had renal failure, proteinuria and microhaematuria. Renal biopsy disclosed either diffuse proliferative (3 cases) or focal necrotising glomerulonephritis with crescents (2 cases). One patient had IgM-IgG mixed cryoglobulinaemia (type II). Four patients died of complications of their CL. Hepatocellular carcinoma was found in 1 case. In the patient without renal biopsy renal function improved following steroids and cyclophosphamide. The pathogenesis of this syndrome of cutaneous vasculitis with severe glomerular involvement in CL is unknown but could be immune-complex mediated.

Aged↗
PubMed1985

Adverse effects secondary to the treatment with plasma exchange.

Side effects and their relationship with the material used were analyzed in 748 plasma exchanges (PE) performed in 75 patients. The total incidence of acute and mild adverse effects (chills and/or fever, paraesthesias, allergic reactions, acute anaemia, vasovagal reactions, abdominal pain and hypotension) was 18.04%. Two patients developed an episode of left cardiac insufficiency. One patient in whom all PE were performed with fresh frozen plasma (FFP) developed metabolic alkalosis. Three patients developed sepsis during treatment with repeated PE and immunosuppressive drugs; in these three patients a permanent vascular inlet was used (shunt or catheter). All patients in whom only FFP was used as replacement solution developed non-A, non-B hepatitis. Neither haemorrhagic nor thrombotic episodes were observed in these patients. It is of the greatest importance to choose the most suitable material for each patient and to develop a careful technique in order to avoid these complications during treatment with PE.

Abdomen↗
PubMed1984

Electron-dense deposits in the renal arterioles of two patients with hypersensitivity vasculitis.

Immune complex deposition in the vessel wall is presumed to be the major pathogenetic mechanism leading to hypersensitivity vasculitis. Despite this, histologic evidence of vascular immune complex deposition such as that provided by electron-dense deposits has been reported only rarely in dermal vessels and never in visceral organs. The cases of two patients with hypersensitivity vasculitis affecting primarily the skin and the kidney are reported. Clinical renal involvement was manifested by proteinuria, hematuria, and a moderate increase in serum creatinine in one case. Renal biopsy showed minimal glomerular changes in one patient and focal necrotizing glomerulitis in the other. The arterioles appeared normal on light microscopic examination. However, obvious electron-dense deposits in the arteriolar wall could be demonstrated electron microscopically in both cases. This observation lends strong support to the theory of immune-complex-mediated vascular damage as the main pathophysiologic mechanism in vasculitis with visceral involvement.

Adult↗
PubMed1983

Beta adrenergic modulation of extrarenal potassium disposal in terminal uraemia.

In order to study the effect of epinephrine on potassium (K) metabolism, an epinephrine infusion (0.1 micrograms/kg/min for 30 min) was carried out in 12 essentially anuric and usually hyperkalaemic haemodialysis patients, 72 hr post-dialysis. Two groups emerged, group I (five patients) serum K decreased at least 0.75 mEq/L (from 6.6 +/- 0.2 to 5.4 +/- 0.1 mEq/L) and there were increases in heart rate, serum glucose and insulin values, group II (seven patients), serum K did not decrease and heart rate remained unchanged, but serum glucose and insulin increased slightly. Plasma renin, aldosterone and arterial pH did not change in either group. Propranolol blocked the epinephrine induced decrease in serum K in group I patients. Patients from group II had higher pre-infusion endogenous epinephrine concentrations than patients from group I. In haemodialysis patients beta adrenergic stimulation enhances extrarenal K disposal but about 50 per cent of patients fail to respond, perhaps because of receptor occupancy due to higher endogenous epinephrine concentrations.

Adrenergic beta-Agonists↗
PubMed1983

Plasmapheresis induced recovery from renal failure in mesangiocapillary glomerulonephritis of acute onset.

Plasmapheresis (PE) was used in the treatment of three patients with biopsy proven mesangiocapillary glomerulonephritis (MCGN) of acute onset and renal failure. The percent of glomeruli with extracapillary proliferation varied from 40 to 90 per cent. Following PE, there were reductions in serum creatinine of 66 per cent, 61 per cent and 82 per cent in patients, one, two and three respectively. Plasmapheresis proved effective in a second episode of renal failure in patient three. After the completion of PE, renal function has remained stable in all patients for periods ranging from two to 12 months. However, haematuria and heavy proteinuria persist in every case. PE appears to facilitate recovery from renal failure in MCGN of acute onset, possibly by removing circulating mediators of acute inflammatory glomerular damage.

Acute Kidney Injury↗
PubMed1981

Acute and rapidly progressive forms of glomerulonephritis in the elderly.

This article presents a comparison of acute glomerular nephritis (AGN) with rapidly progressive glomerular nephritis (RPGN) in patients aged 60 or older. In 7 elderly patients with AGN, the renal disease was preceded by skin infection (4 cases), sore throat (2 cases), or pneumonia (1 case). The 7 patients with RPGN had no history of prior infection. Both AGN and RPGN were manifested clinically as acute renal failure, but the RPGN patients had significantly higher serum creatinine levels and lower hematocrit readings. Hypocomplementemia was a feature only of AGN. The biopsy specimens from patients with RPGN showed crescents in 50--100 percent of the glomeruli, whereas specimens from patients with AGN showed no significant extracapillary proliferation. Six AGN patients recovered and 1 died. Despite dialysis, 4 RPGN patients died and the remaining 3 require maintenance dialysis. It is concluded that AGN in the elderly is more common than previously believed, frequently follows skin infections, and has a reasonably good prognosis. In contrast, RPGN, also not rare in the elderly, has a much worse prognosis.

Acute Disease↗
PubMed1981

Postsynaptic adrenergic unresponsiveness in hypotensive haemodialysis patients.

In order to ascertain the significance of autonomic dysfunction in hypotensive maintenance haemodialysis patients, plasma norepinephrine (NE) was measured by radioenzymatic assay in 15 nondiabetic uraemic subjects of similar age and time on dialysis, five of them chronically hypotensive and 10 normotensive. Hypotensive patients had: 1) Significantly higher NE levels than their normotensive counterparts, both in basal conditions and after orthostatism and 2) significantly lesser increments in mean arterial blood pressure during a NE infusion than the normotensive group. Rather than implicating a mechanism based on autonomic neuropathy, our results suggest that in haemodialysis patients with chronic hypotension, there is a defect located at the adrenergic postsynaptic level.

Adult↗