PubMed Health⌕ Search

Biomedical subjects

E Vázquez Martul

Publications and source records attributed to E Vázquez Martul.

At least 19 recordsLinked to original sources
PubMed2004

Severe cardiac allograft dysfunction without endomyocardial biopsy signs of cellular rejection: incidence and management.

Acute dysfunction of cardiac allograft without evidence of cellular rejection is a potentially fatal complication of heart transplantation that suggests a humoral origin. In clinical practice, humoral rejection (HR) is suspected when there is evidence of severe allograft dysfunction but endomyocardial biopsy (EMB) shows no evidence of cellular rejection. Between April 1991 and August 2003, 12 patients (2.74%) among 438 heart transplants displayed this condition. Time post-heart transplant (HT) was 21.3 +/- 24.7 months (range 2 to 72 months). Immunofluorescence studies using classic markers were negative. All patients were treated with methylprednisolone "bolus" and plasmapheresis until clinical recovery, after which their immunosuppressive regimens were modified. Eleven of the 12 patients recovered satisfactory allograft function. In this series the incidence of suspected HR was low. Unlike other studies, we observed HR not only soon but also even years after HT. Plasmapheresis seems to be an effective treatment.

Adult↗
PubMed2004

Autopsy-determined causes of death in solid organ transplant recipients.

The aim of this study was to review the main causes of death as determined by autopsy of deceased solid organ transplant recipients. We reviewed 156 autopsies including 76 heart, 32 liver, 29 kidney, and 19 lung transplant recipients. The mean survival period varied depending on the transplanted organ: namely heart, 497 days; liver, 189 days; kidney, 1124 days; and lung, 252 days. Infections were the most common cause of death in all groups, varying from 21% in heart to 63% in lung recipients. Acute rejection, chronic rejection, and malignancies only appeared as the cause of death in heart recipients (14.5%, 9.2%, and 4%, respectively). Primary graft failure was present in heart (15.7%), kidney (3.4%), and lung (5.3%) recipients. The highest rate of surgical complications as a cause of death was observed in heart transplant recipients. In all groups there was a significant percentage (about 30%) of other pathologies that were responsible for death, such as pulmonary embolism, central nervous system pathology, acute pancreatitis, digestive hemorrhage, and acute myocardial infarction. Our results emphasize that infections are the main cause of death within the first year posttransplant, independent of the organ transplanted.

Autopsy↗
PubMed2004

[Renal xenotransplantation from hDAF pig to baboon. Experience and review].

UNLABELLED: The renal xenotransplant could be the solution on the demand of organs for transplantation. We present here our experience and review the actual status of the xenotransplant. METHODS: We have done 20 xenotransplants from transgenic pig h DAF to baboons, with four protocols of immunosuppression. All the hosts were treated with GAS 914. Group A: Cyclophosphamide, Cyclosporine, Mycophenolate, and Steroids (n = 10). Group B: Cyclophosphamide, Cyclosporine, FTY 720, and Steroids (n = 3). Group C: Basiliximab, Cyclosporine, Mycophenolate, and Steroids (n = 3). Group D: Basiliximab, FTY 720, Everolymus, and Steroids (n = 4). RESULTS: The duration of the xenografts ranged between 1 and 31 days. The function of the xenografts in relation to the type of immunosuppression were not significantly different: A) 7 days, B) 8 days, C) 8 days, and D) 9 days. CONCLUSIONS: 1. The cold ischemic time of the graft, has influence in the initial function of the kidneys but not in the evolution and duration of the graft. 2. The hyperacute rejection has been overcome with the utilization of transgenic pigs. The graft failure was due to acute humoral rejection that was not aborted by the actual inmunosupressors. 3. It is necessary to develop new immunosuppression protocols, through new knowledge of their pharmacology and the physiology of the xenografts, and at the same time it is important to avoid the potential risk of transmission of animal infections.

Animals↗
PubMed2004

[Association between membranous glomerulonephritis and Crohn's disease].

We report the case of a 37 year old man who suffered from Crohn's Disease (CD), and was receiving treatment with mesalazine (5-ASA). Nine years after the diagnosis, because of detecting a slight proteinuria, a renal biopsy is made, being the anatomo-pathologic result compatible with membranous glomerulonephritis (MGN). Checking previous literature we have only found two cases reported of MGN in coincidence with Inflammatory Bowel Disease (IBD), one in association with Ulcerative Colitis and the other with Crohn's Disease in a 12 years old boy. This is, therefore, the second case presenting MGN associated with CD and the first in an adult patient.

Adult↗
PubMed2002

[Typical renal metanephric adenoma. Conservative surgery].

Metanephric Adenoma is uncommon renal tumor included in the complex group of the embryologics or nefroblastics renal tumors. Generally occurs in young females and usually has excellent prognosis. It's important to differentiate of malignant variants, particularly renal cell papillary carcinoma, metanephric adenosarcoma and adult Wilms tumor. The suspicion and intraoperative analysis of the tumor can to facilitate the use of conservative renal surgery in order to avoid unnecessary radical and aggressive surgery. To exist cases of metastatic metanephric adenoma, and the totally benign characteristic of the metanephric adenoma and the malignant potential isn't totally clarify.

Adenoma↗
PubMed2001

Nephrotic syndrome due to thrombotic microangiopathy (TMA) as the first manifestation of human immunodeficiency virus infection: recovery before antiretroviral therapy without specific treatment against TMA.

BACKGROUND: Among the possible renal complications that can develop a human immunodeficiency virus- (HIV) infected patient, thrombotic microangiopathy (TMA) is one of them. This is a type of vascular lesion more common in HIV patients than in normal population, and sometimes it can be the first manifestation of the HIV infection. METHODS: We present a patient with TMA in whom the subsequent investigation to find the cause of TMA revealed HIV infection and Giardia Lamblia in stool. RESULTS: Before antiretroviral therapy was started the patient began to show recovery of the hemolytic anemia, recovery of the nephrotic syndrome and partial remission of the proteinuria, so that he did not receive specific therapy for TMA. CONCLUSIONS: HIV infection should be suspected in patients presenting with TMA, and a HIV test should be routinely performed as part of the initial clinical evaluation of TMA. If the patients have not developed acquired immunodeficiency syndrome, the prognosis of TMA is equal to non-infected ones.

AIDS-Associated Nephropathy↗
PubMed1996

[The determination of monoclonality in B-cell lymphomas using the polymerase chain reaction technic on paraffin-embedded material].

BACKGROUND: Clonal rearrangements of immunoglobulin are useful in the diagnosis of B-cell lymphomas. The value of the polymerase chain reaction (PCR) with consesuated primers in the variable (V) and joining (J) region is now well established. METHODS: Forty cases of B-cell lymphomas and 10 patients with reactive lymphoid proliferations have been studied. All cases were studied with two different semiacotated techniques, with similar primers in the J region (LJH and VLJH) and changing the primers of the V region (Fr2A and Fr3A). RESULTS: A 100% specificity and positive predictive value were obtained with both techniques. The sensitivity was 90% with Fr2A and 82% with Fr3A, but in 20% of the studies with Fr2A the extracted DNA was insufficient to perform the study while it could be done with Fr3A in all cases. The negative predictive value was 76% with Fr2A and 58% with Fr3A. CONCLUSIONS: Both techniques showed a good sensitivity, optimal specificity and positive predictive value, with low negative predictive value. Although the results are somewhat higher with Fr2A, this technique needs well preserved DNA and it can be an important set back when we deal with formaldehyde fixed, paraffin embedded tissues.

Base Sequence↗
PubMed1992

[Calcified bladder oat cell associated with hypercalcemia and hypophosphoremia].

Description of a 69-year old male patient presenting calcified vesical tumour which, following a pathoanatomical study was shown to be an non-differentiated oat cell carcinoma associated to transitional carcinoma and adenocarcinoma. Biochemically it presented hypercalcemia and hypophosphoremia and the electron microscope study demonstrated the presence of neurosecretion granules. The immunohistochemical techniques were negative for protein S-100 and cytokeratins, but positive for the membrane epithelial antigen and the neuro-specific enolase. The patient was treated by transurethral resection and polychemotherapy, presenting an initially favourable response but dying 18 months later after widespread metastasis. These data are in agreement with those obtained from the literature review carried out with regard to clinical picture, pathoanatomical studies, aggressiveness and overall poor prognosis with this type of tumours. In our view, the tumour's mixed composition supports an origin of pluripotential cell (steam cell). Presence of neuroendocrine syndromes associated to oat cell vesical tumours is an unusual fact related to the tumour's hormonal secretion.

Adenocarcinoma↗
PubMedDate not supplied

[Value of PSA and (pre- postoperative) Gleason in predicting the potential lymphatic involvement in patients with prostatic cancer].

OBJECTIVE: To determine the possibility of selecting patients at risk for lymph node involvement prior to radical prostatectomy utilizing PSA concentration and/or the Gleason score. METHODS: We reviewed the records of 52 patients with tumor stage T1 to T3, who had undergone lymphadenectomy; of these, 50 patients underwent radical prostatectomy. The predictive values for PSA and the Gleason score and their utility in predicting risk of lymph node involvement were analyzed. RESULTS: Of the 52 patients, 10 (19%) had lymph node involvement. Nine of 26 patients (35%) with PSA > 20 and 9 of 21 patients (42%) with a Gleason score > 7 had lymph node involvement. No patient with PSA < 15 or Gleason score < 5 and none of the 24 patients (57%) with PSA < 20 and Gleason score < 7 had lymph node involvement. The preoperative biopsy was understaged in 21 patients (41%); of these, 16% had a Gleason score of 5-6. Two of these patients with PSA > 20 micrograms/ml had lymph node involvement. CONCLUSION: PSA concentration and the Gleason score are useful in predicting the risk of lymph node involvement. Patients with PSA < 20 and a Gleason score of < 7 can be considered to be at no risk and staging lymphadenectomy could be unnecessary. Although the preoperative Gleason score appears to have a predictive value, the possibility of understaging should be taken into account. In this regard PSA can be useful in identifying those patients at risk.

Aged↗