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Biomedical subjects

F Acosta

Publications and source records attributed to F Acosta.

At least 127 records · Page 7Linked to original sources
PubMed1994

Life quality of patients undergoing liver transplantation.

The aim of this study was to assess the life quality of a group of patients who had undergone liver transplantation using (1) a psychological test to evaluate family relations, work activity, emotional state and social relationships; (2) the quantification of hospital dependence and degree of fitness for work. Included in the study were 32 patients using the following criteria: diagnosis of hepatic cirrhosis and minimum posttransplant follow-up of 6 months. The average age of the study population was 44.8 +/- 10.5 years; there were 23 males and 9 females, with an average follow-up of 15 months. The psychological test used was the Quality of Life Scale (QLS) which consists of 21 items each scoring from 1 to 6 points. The questionnaire was completed before transplantation by all the patients, and after transplantation by 32 patients at 6 months, 20 at 12 months and 12 at 24 months. Hospital dependence was evaluated by the number of admissions and number of days per admission. Lastly, we compared fitness for work before transplantation and at 1 and 2 years after transplantation. The QLS test showed a post-transplant improvement in the four aspects assessed, particularly in the personal aspects (emotions and family) (P < 0.001). Hospital dependence following liver transplantation decreased significantly compared with the pretransplant situation (P < 0.01). Finally, the post-transplant percentage of unfitness for work decreased with time, reaching a significant differences 2 years after transplantation (P < 0.05).

Adult↗
PubMed1994

Hepatic artery complications after liver transplantation.

We present the arterial complications arising from 100 orthotopic liver transplants (OLT) carried out in 87 consecutive patients. Mean patient age was 42.5 +/- 12.8 years (7-63). There was a predominance of male patients (67%). The most common indications were hepatic cirrhosis (53%) and severe acute hepatitis insufficiency (14%). The donor liver presented 29 arterial malformations, mainly a left hepatic artery arising from the left gastric artery, either as a single or associated anomaly. Only six arterial complications appeared in 4 of the 87 patients. Of these six, four corresponded to arterial thrombosis, and the remaining two to arterial stenosis and a ruptured mycotic aortic aneurysm. Two of the 4 patients had a double arterial complication (one had arterial thrombosis in 2 of the 3 grafts, and the other presented arterial thrombosis and aortic rupture). No arterial complications were related to arterial anomalies in the donor liver. Three of the 4 patients died from the complication. The 1-year actuarial survival rate in our series is 77.5%. In conclusion, arterial complications are infrequent in our series (6%) but do carry a high mortality rate (75%).

Adult↗
PubMed1993

Reoperation for biliary tract complications following orthotopic liver transplantation.

Biliary tract complications were analysed after 54 orthotopic liver transplantations performed in 49 patients over a 2-year period. Reconstruction of the bile duct consisted of end-to-end choledochocholedochostomy over a T tube in 47 cases and Roux-en-Y choledochojejunostomy in seven (two for sclerosing cholangitis, one for secondary biliary cirrhosis, four retransplants). The T tube was withdrawn 12-16 weeks after operation in all but two patients (2-3 weeks). There was no intraoperative mortality. Eight patients (16 per cent) died during the first month and the 1-year actuarial survival rate was 75 per cent. Early biliary complications (up to 3 months after operation) consisted of five bilomas, for which ultrasonographically guided drainage was effective in three and surgical drainage necessary in two. Late biliary complications (3 months onwards) consisted of biliary peritonitis following T tube removal (four patients; reoperation was required in all four) and necrosis of the bile duct secondary to a late arterial thrombosis (one). The incidence of reoperation as a result of early biliary complications was low (two patients), but higher for biliary peritonitis following T tube removal.

Adolescent↗
PubMed1992

[Biliary complications in the follow-up of 54 orthotopic liver transplant patients].

UNLABELLED: We analyze the biliary tract complications after 54 orthotopic liver transplantation in 49 patients during a 2-year period. Biliary tract reconstruction was achieved by a choledochocholedochostomy over a t-tube in 47 cases and by a Roux-en-Y choledochojejunostomy in 7 cases (2 sclerosing cholangitis, 4 retransplants and 1 secondary biliary cirrhosis). The t-tube was removed between the 12-16 postoperative week in all cases except in two patients (2 and 3 postoperative week). RESULTS: There was not intraoperative mortality. During the first postoperative month 8 patients died (16.3%) none of them because a biliary complications. The one year actuarial survival of patients was 74.6%. During the (first three postoperative months) we observed 5 patients with a bile leak (biloma). In 3 cases the ultrasonographic drainage was effective and in two cases a surgical drainage was necessary. After the 3rd postoperative month, four patients developed a biliary peritonitis after t-tube removal and a reoperation was required in all cases. Finally, 1 patient suffered a hilar biloma cavity due to hepatic artery thrombosis. We stress the low incidence of reoperations due to early biliary complications (2 cases) and the high incidence of biliary peritonitis after t-tube removal.

Adolescent↗
PubMed1992

[Orthotopic liver transplantation in the Budd-Chiari syndrome. A case report].

A patient with Budd-Chiari's syndrome of idiopathic etiology, received an emergency liver transplant because of terminal liver insufficiency, including encephalopathy, functional renal failure and progressive deterioration of coagulation. The diagnosis was confirmed by biopsy. The transplanted liver was from a patient with the same blood group and the preserving solution was Euro Collins. No veno-venous by-pass was necessary during operation. Anticoagulation was started from the immediate post-operative stage, as well as triple immunosuppressive therapy with azathioprine, cyclosporine and corticoids. The patient is asymptomatic twenty months after transplantation.

Adult↗
PubMed1991

Characterization of functional changes in macular holes and cysts.

Precise characterization of functional loss in small retinal lesions is difficult with conventional techniques. Using the scanning laser ophthalmoscope, the authors evaluated functional changes and fixation behavior in 26 eyes with macular holes and 15 eyes with macular cysts. A dense scotoma was present over all macular holes; 24 had no detectable functional alteration at the margins of the hole, and fixation was above the horizontal meridian in all eyes. Nine eyes with cysts had no detectable functional loss over the cyst. Only two eyes had small areas of dense scotoma within the cyst area, and four had areas of relative scotoma. Fixation was central in all eyes. Characterization of functional changes is helpful in differentiating holes from cysts. Photocoagulation at the margin of the holes may result in further functional damage.

Aged↗
PubMed1988

Biofeedback and progressive relaxation in weaning the anxious patient from the ventilator: a brief report.

Weaning patients with chronic obstructive pulmonary disease from mechanical ventilators is occasionally a long and difficult process complicated by the patient's fear of losing his or her breath during the weaning procedure. A case is presented of an anxious 58-year-old man who was taught to relax using biofeedback and progressive relaxation during aerosol "T-piece" weaning trials. The relaxation effect was elicited by having the patient contract and relax specific muscle groups in a progressive manner, to experience the difference between the states. Ear oximetry served as physiologic feedback as well as a safety feature in the event of oxygen desaturation during exercise. During and after the exercises he felt secure breathing without the ventilator as measured by the physiologic parameters: heart rate, respiratory rate, and oxygen saturation determined by oximetry.

Biofeedback, Psychology↗
PubMed1987

On the pathogenesis of idiopathic guttate hypomelanosis.

Idiopathic guttate hypomelanosis is a common leukodermic dermatosis of obscure origin, consisting of small 2- to 5-mm achromic or hypopigmented macules, mainly affecting the exposed upper and lower extremities. In a group of 400 consecutive dermatologic patients, idiopathic guttate hypomelanosis was much more prevalent in women than in men. However, in both sexes this prevalence became more common with advancing age. In another group of fifteen patients with idiopathic guttate hypomelanosis and fifteen normal controls matched by age, sex, and skin type, the following was found: A cause-effect relationship between chronic actinic exposure and the development of idiopathic guttate hypomelanosis could not be established by statistical studies. A family aggregation survey disclosed a higher prevalence of idiopathic guttate hypomelanosis in the family of patients with idiopathic guttate hypomelanosis than in the control group. Epithelial atrophy, patchy absence of melanocytes and melanin, flattening of the rete pegs, and basket weave hyperkeratosis were the most prominent histologic findings of idiopathic guttate hypomelanosis. Minigrafts of normal skin implanted in idiopathic guttate hypomelanosis lesions did not modify the achromic defects, whereas intralesional triamcinolone with or without grafts improved the appearance of these lesions.

Adult↗