Biomedical subjects
E Vilaplana
Publications and source records attributed to E Vilaplana.
[Hypervitaminosis D. Review of fifteen cases].
Fifteen cases of hypervitaminosis D in childhood are reviewed. In all of them, vitamin D was given following medical prescription. In four occasions, excessive dosage of vitamine D impaired the evolution of a previous nephropathy. The clinical, analytical, radiological and histological findings as well as the therapeutical aspects are commented. Hypercalcemia, hypercalciuria, polyuria with hypostenuria, renal failure, bone lesions and nephrocalcinosis are the most prominent features of the picture. Occasionally, arterial hypertension and glycosuria were found. Prednisone, thyrocalcitonine and phosphates were used as therapeutical means. In spite of nephrocalcinosis and renal failure generally present at diagnosis, the clinical course was rather good.
[Bartter's syndrome. Pathophysiology in three cases (author's transl)].
The primary pathologic defect in Bartter's syndrome is unknown. Three patients have been studied. In two of them, with normal intra-erythrocite sodium concentration, authors prove the existence of an impaired proximal tubular sodium reabsorption. In the last case, with a high intra-erythrocite sodium concentration, this impaired sodium reabsorption was localized in the proximal and distal tubular portions.
Studies on the site of renal sodium loss in two patients with cystinosis. Effects of hydrochlorothiazide on tubular sodium reabsorptive mechanisms.
The purpose of this study was to examine the effect of hypotonic saline diuresis on two patients with cystinosis, trying to localize the site of renal sodium loss. At the same time, we have performed the same hypotonic saline infusion under hydrochlorothiazide administration. Results seem to prove the proximal tubular localization of the salt-wasting syndrome in cystinotic patients. On the other hand, these results suggest that hydrochlorothiazide effect can be related to the hypovolemia due to the distal tubular action of hydrochlorothiazide that could inhibit the 'third' natriuretic factor, thus increasing the proximal tubular sodium reabsorption.
[Cytodiagnosis of lesions of the vulva (author's transl)].
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[Natural history of pyelonephritis (author's transl)].
Natural history of pyelonephritis is reviewed through the analysis of 971 cases of urinary infaction diagnosed and treated during the last eight years.
Endometrial and endocervical brushing techniques with a Medhosa cannula.
A new technique for obtaining endometrial material using the Medhosa Cannula is described. This method is also useful to obtain samples from the endocervix. The Medhosa Cannula is made of flexible plastic. It is 30 cm long and has thin fins on its distal end which, guided by an introduction cone, permit endometrial and endocervical brushing. Six hundred cases are reported. Concomitant histopathological studies were performed in 40 per cent of the patients. There were two false negative cytologic reports (0.88%) and one false positive (6.66%). This is a simple, rapid, innocuous and economical technique, thus fulfilling the prerequisites for routine cytodiagnostic methods. Adequate material was always obtained.
[Review of 15 cases of hypervitaminosis D].
In our experience, hypervitaminosis D, which at present should only be a historic remembrance in pediatrics, is still a frequent cause of hipercalcemia in childhood. It is easy understand that its appearance should turn out to be a complication in the treatment of hypoparathyroidisms or in vitamin D resistant rickets, but its persistance as a purely iatrogenic diseases is at present inexplicable. The frequency with which we have seen it has led us to review 15 cases where erroneous administration of high doses of vitamin D has resulted in serious clinical, biological and anatomical problems.
[Jeune syndrome and fungal bronchial asthma].
A young girl suffering from asphyxiating thoracic dystrophy secondary to bronchial asthma was submitted to an allergologic evaluation. We have not found these processes associated in what some authors have called the "minor forms" of the Jeune syndrome. Osteochondrodysplasia, called in recent papers thoracic-pelvic-phalangeal dysplasia, is characterised by marked retraction of the thoracic cage associated with changes in the bones of the pelvis and extremities. We placed special emphasis on the classification of the different forms of presentation as being of greater or lesser severity from a clinical point of view, and stressed the importance of associated abnormalities (such as renal complications, as in the case of our patient) with respect to the eventual prognosis. The diagnosis of allergy is based on a detailed clinical history, positive results to cutaneous testing and the presence of specific IgE, together with the results of nasal provocation. The recording by rhinomanometre, of the temperature and pressure, and the assessment of the nasal mucosa following contact with the suspected allergen was also of help. Finally, having established the diagnosis, we advised the corresponding treatment, both from the allergic and renal viewpoints and concluded with an evaluation of the prognosis as conditioned by the renal pathology.
[Cystinolysinuric lithiasis].
Cystinuria is a disease characterized by the excessive elimination of cystine and of dibasic amino acids (lysine, arginine, and ornithine) through urine of homozygotes. This study included 6 children complaining of abdominal pain with or without hematuria. The existence of renal radio-opaque lithiasis was confirmed in 5 of them and in the sixth, it was vesical. The clinical and analytic data were practically normal with the exception of the qualitative test of the amino acid urinary excretion that showed increase in urinary excretion of cystine. Likewise, percentages of tubular reabsorption were pathological in all the patients showing values between 35.4% and 74%. The diagnosis of systini-lysinuric lithiasis was established through amino acid excretion study in the six patients which was below normal; it fluctuated between 36% and 74%. Lysine, together with cystine, was the most frequently affected.