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Biomedical subjects

C Aguirre

Publications and source records attributed to C Aguirre.

At least 19 recordsLinked to original sources
PubMed1992

[Use of magnetic resonance in the diagnosis of neuro-cryptococcosis in the acquired immunodeficiency syndrome: study of 4 patients].

Neuro-cryptococcosis is a common opportunistic infection in AIDS or HIV infected patients. From a series of 10 neuro-cryptococcosis the four of them studied by magnetic resonance (MR) are reported. In AIDS patients a high suspicion of opportunistic infection of the CNS is needed as exemplified by two of the four patients who only presented cephalalgia. The other two patients suffered additional symptoms and signs of meningeal and CNS involvement, such as nuchal rigidity, cranial nerve palsies, papilloedema, gait ataxia and dismetria. Diagnosis was achieved (confirmed) by a positive culture, serology or indian ink test in CSF. CT scan did not contribute to the diagnosis and management of the patients. In contrast MR, showed in three of them a peculiar pattern of small, confluent, high-signal lesions, roughly symmetrically placed in the basal ganglia and the internal capsule. They probably correspond to the dilated Virchow-Robin spaces through which torulae migrate from the subarachnoid space.

Acquired Immunodeficiency Syndrome↗
PubMed1992

[Transurethral thermotherapy in prostatic adenoma].

Microwave thermotherapy is considered to be an alternative to conventional surgical treatment of benign prostatic hyperplasia (BPH). Our initial experience of the first six months shows this technique has achieved objective improvement of the symptoms and uroflowmetry, as well as a significant reduction of postmicturition residual urine. It carries a minimal morbidity, no mortality and has permitted recovery of micturition in over 90% of the patients with urinary retention.

Aged↗
PubMed1992

[Current diagnosis of renal cancer: clinical experience with 71 cases].

The diagnosis of renal cell carcinoma was frequently delayed due to the anatomic location of kidneys. Recently, the development of echographic imaging techniques has drastically changed this situation. In this retrospective review of 71 patients with renal cell carcinoma, the diagnosis was made incidentally during a routine abdominal ultrasound examination in 49% of cases. These patients, has lower stage and smaller tumors than symptomatic patients. Among the latter, hematuria was the principal presenting symptom. The early diagnosis of renal cell carcinoma allows more conservative surgical procedures and has a favorable effect on long term survival.

Adult↗
PubMed1992

[Renal oncocytoma: 4 cases].

Oncocytomas are tumors characterized by cells with an eosinophilic cytoplasm. Renal oncocytomas were described in 1942. Among 46 consecutive patients operated on for renal tumors, oncocytomas were found in 4 (8.7%). In spite of a supposedly benign nature, renal oncocytoma cannot be adequately differentiated from renal adenocarcinoma by imaging techniques. Therefore, we recommend radical surgery as the treatment of choice in these patients.

Adenoma, Oxyphilic↗
PubMed1992

[Endocarditis caused by Lactobacillus].

Endocarditis due to Lactobacillus is rare. Its main features were a subacute course and greater difficulties for achieving a complete recovery even using appropriate antimicrobial therapy with serum levels above MIC. We present one case of Lactobacillus endocarditis in a patient with allergy to penicillin, due to a vancomycin-resistant strain. She was successfully treated with clindamycin and gentamicin. We emphasize the need and importance of sensitivity tests and antibiotic tolerance when choosing an optimal treatment for this infection.

Adult↗
PubMed1992

[Cryptococcal meningitis and AIDS. Clinical description of 10 patients].

We have studied 10 patients with cryptococcal meningitis and AIDS. Nine of them were intravenous drug users and four have been previously diagnosed of AIDS. In 60% of them cryptococcal meningitis was the first opportunistic infection, and as group represented only 6.3% of our 158 patients with AIDS on the same period. The most common symptoms were: malaise (100%), headache (80%), fever (60%), meningeal signs (50%). Two of them had focal neurological disease. CSF culture and serum cryptococcal antigen test were positive in 90%, the Indian ink in 77% and blood cultures in 30% of the cases, while indian ink preparation did it in 77%. MRI showed bilateral small lesions, deeply located, in 3 cases; it was also useful to prove optical tract lesions in a patient with blindness as a result of cryptococcal meningitis. We had treatment successes in 80% of the cases, all patients being treated with amphotericin B, alone in 4 and amphotericin B plus fluorocytosine in 6. Two patients died within the first 2 weeks. Maintenance therapy with fluconazole was effective and well tolerated, with 3 patients dying from causes other than cryptococcal meningitis. We recorded a survival rate over 12 months in 33% of patients.

Acquired Immunodeficiency Syndrome↗
PubMed1991

A multicenter double-blind study comparing lovastatin and gemfibrozil in the treatment of primary hypercholesterolemia.

The efficacy and tolerability of lovastatin and gemfibrozil were compared in a randomized double-blind 12-week study including 182 patients with primary hypercholesterolemia, from 7 hospitals in Spain. Inclusion criteria were total-cholesterol of at least 250 mg/dl and triglycerides less than 350 mg/dl. Patients were stratified in two groups: group 1, cholesterol less than 300 mg/dl, and group II, cholesterol equal to or more than 300 mg/dl. Patients were randomized to gemfibrozil (600 mg b.i.d.) or lovastatin (20 mg q.p.m., group I and 40 mg q.p.m., group II). If after 6 weeks of treatment cholesterol remained above 200 mg/dl, lovastatin does were doubled. In group I, lovastatin decreased cholesterol by 20%, LDL-C by 28%, and triglycerides by 17%, and increased HDL-C by 8%. In group II the results were: -26%, -33%, -19% and +6% respectively. The corresponding results with gemfibrozil were: -8%, -9%, -28% and +14% (group I); and -13%, -14%, -33% and +9% (group II). In both groups, lovastatin was more effective in reducing cholesterol and LDL-C (P less than 0.001) and gemfibrozil in reducing triglycerides (P less than 0.05 group I and P less than 0.01 group II). Both drugs were well tolerated. Thus, lovastatin and gemfibrozil are effective lipid-lowering agents; lovastatin has more pronounced effects in patients with hypercholesterolemia.

Adult↗
PubMed1990

Decrease in penbutolol central response as a cause of changes in its serum protein binding.

Penbutolol is a beta-adrenoceptor antagonist that is extensively bound to alpha 1-acid glycoprotein (alpha 1-AGP), a protein that increases in inflammatory diseases thereby binding more drug in such conditions. Changes in serum binding can lead to modifications in the pharmacokinetics and pharmacodynamics of a drug, therefore, the central effect (as the anticonvulsant response) and brain uptake of penbutolol given intravenously to mice with experimental inflammation have been measured. A significant decrease of the central effect of penbutolol and its brain uptake was seen in diseased when compared with control animals (P less than 0.01). A parallel decrease in free fraction of penbutolol in diseased vs normal animals was detected. These results suggest that there is an increase in serum binding of basic drugs related to increments in alpha 1-AGP concentration, which reduces their central pharmacological effect.

Animals↗
PubMed1990

[Cell-mediated lympholysis in kidney transplantation].

Kidney transplant survival has been increased with the use of cyclosporine (CyA) and antilymphocyte globulin (ALG), in spite of which both significant morbidity and mortality persist. On the other hand, immunosuppression is mostly based on the state of renal function and not on the monitoring of immunologic parameters. Therefore, it is important to apply immunological techniques for early diagnosis of over-immunosuppression and eventually to stop maintenance immunosuppression completely. Seventeen kidney transplant recipients (3 from cadavers and 14 living related) were studied. They were initially treated with either 3-5 mg/kg/d CyA, ALG and 0.5 mg/kg/d prednisolone (current treatment) or with 2 mg/kg/d azathioprine and 1 mg/kg/d prednisolone (conventional treatment). Cell-mediated lympholysis (CML) was performed between receptor and, alternatively, specific donor and third unrelated control. CML figures were higher with conventional treatment (14.73 +/- 1.69) than with current treatment (3.14 +/- 0.8) (Table 2). CML responses between receptors and third unrelated donors increased significantly with conventional therapy to 77.67 +/- 8.17, a value not different from that encountered between unrelated controls (72.7 +/- 3.9). The CML responses with the current therapy increased significantly to 34.25 +/- 2.54 but remained lower than that observed in the other group. The data suggest that the use of GAL and CyA leads to a nonspecific decrease of the immune response. It remains to determine whether or not the pattern evolves later to a donor specific hypo-response, as observed in the present study with the group with conventional treatment, confirming previous results.

Antilymphocyte Serum↗
PubMed1990

[Rigid ureteroscopy: the indications and results in 154 patients].

We analyzed the indications and results of rigid ureteroscopy performed in 154 consecutive patients. Treatment of ureteral lithiasis was the main indication. Success rate for this procedure was 95.4%. Evaluation of hematuria and treatment of ureteral stenosis constituted most of the remaining indications for the procedure.

Adolescent↗
PubMed1990

[Percutaneous nephrolithectomy. The results in 180 procedures].

We performed percutaneous lithectomy in 180 patients with renal stones. A single stone was present in 92, multiple stones in 23, coral shaped stones in 15 and a bilateral location existed in 3 patients. Access to the pyeloureteral tract was obtained in every patients. Successful removal of the stone was achieved in 97.2% of patients. There were no deaths and only few mild complications. We believe that percutaneous approaches is the technique of choice for removing renal stones.

Adolescent↗
PubMed1990

[Hepatitis B virus in patients with renal transplant. Report of 52 cases].

Hepatitis B virus (HBV) is a high risk factor in the frequently found liver involvement of renal transplant recipients. As in other immunosuppressed patients, these often follow a course of slight jaundice, with a progressive tendency and great replicative and infectious power. Also, in addition to an increased incidence of chronic hepatitis (CH) in transplanted when compared with hemodialized patients, specially when HBsAg is present, it is surprising the poor correlation between enzyme levels and the grade of activity of the hepatic lesion. In a retro and prospective study, we present 52 patients of the 73 transplant reviewed. There are 32 men and 20 females, with and average age of 34 years, minimum time on dialysis of 2 months and maximum of 7 years, time of renal transplant from 6 moth to 15 years (average 4.9 years). There were 31 cadaver transplants and 21 live donors. The HBsAg was + in 20 (9 seroconverted), HBeAg was + in 4 (with 2 seroconvertions), hyperbilirrubinemia in 5, hyperalkaline phosphatasemia (2 or more times) in 11 and elevated serum transaminases (SGPT) (3 times or more) in 20 cases. Positive HBsAg plus SGPT x 3 was found on 9 occasions and positive HBsAg with SGPT x 3 in 3 cases. liver biopsy (LB), in those with enzymatic changes and/or positive antigenemia, was performed in 15 instances and there were 5 autopsies. The most important histological findings were: 5 acute viral hepatitis, 2 active chronic hepatitis (CAH), 2 persistent chronic hepatitis (CPH), 5 with fat infiltration and 4 with colestasis.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗