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Biomedical subjects

I Villar

Publications and source records attributed to I Villar.

6 recordsLinked to original sources
PubMed2006

Effect of antimalarials on thrombosis and survival in patients with systemic lupus erythematosus.

Antimalarials have shown beneficial effects on systemic lupus erythematosus (SLE) activity. Our aim was to investigate whether antimalarials protect against thrombosis and influence survival in SLE patients. A prospective cohort including 232 patients with SLE were included in the study at the time of lupus diagnosis. End points were documented thrombosis and death due to any cause. A Cox regression-multiple-failure time survival analysis model was fitted to establish the effect of antimalarials on the development of thrombosis. Kaplan-Meier survival curves and propensity score adjusted-Cox regression analysis were performed to investigate the effect of antimalarials use on survival. Of our subjects, 204 patients (88%) were women. 230 patients (99%) were white. 150 patients (64%) had ever received antimalarials. Median time on antimalarials was 52 months (range three to 228 months). The Cox multiple-failure time survival analysis showed that taking antimalarials was protective against thrombosis (HR 0.28, 95% CI 0.08-0.90), while aPL-positivity (HR 3.16, 95% CI 1.45-6.88) and previous thrombosis (HR 3.85, 95% CI 1.50-9.91) increased the risk of thrombotic events. Twenty-three patients died, 19 of whom (83%) had never received antimalarials. No patient treated with antimalarials died of cardiovascular complications. Cumulative 15-year survival rates were 0.68 for never versus 0.95 for ever treated patients (P < 0.001). Age at diagnosis and propensity score-adjusted HR for antimalarials ever versus never users was 0.14 (95% CI 0.04-0.48). Our study shows a protective effect of antimalarials against thrombosis and an increased survival of SLE patients taking these drugs. These data support the routine use of antimalarials in all patients with SLE.

Adult↗
PubMed1994

[Immune complex glomerulonephritis associated with pulmonary tuberculosis].

A 32 year old man was admitted for dyspnea, hemoptysis, macroscopic hematuria, hypertension (140/100), peripheral edema and hemodynamic decompensation. Lung Xrays revealed pulmonary edema and a cavity in the left apex. Laboratory determinations revealed an altered renal function with increased creatinine and urea levels and nephrotic syndrome. There was leucocyturia, hematuria and cylindruria. The sputum showed a large number of acid-fast bacilli. The patient began anti-tuberculosis treatment with three drugs (isoniacid, rifampicin, pirazinamide). On ultrasonography, both kidneys revealed ecogenic lesions with size, shape and cortico-medular relationship preserved. The patient persisted with altered renal function, steady levels of urea nitrogen, creatinine and potassium, preserved diuresis and hypertension. Bidimensional echocardiogram: LVDD 55 mm, hypoquinetic septum, pericardic effusion, thickened pericardium, pleural effusion, shortening fraction decreased. He received treatment for this congestive cardiac failure and hypertension with enalapril, nifedipine and fursemide. A percutaneous renal biopsy was performed with anatomopathologic diagnosis of diffuse encocapillar proliferative glomerulonephritis with crescents (15%) and total glomerular sclerosis (33%). Immunofluorescence: positive, immune-complexes with IgM and C3. The patient gradually recovered his normal renal function, improved his pleural effusions and normalized his cardiac function. He was discharged in good clinical condition on the 69th day of anti-tuberculosis treatment. An association between pulmonary tuberculosis and glomerulonephritis is discussed. It is proposed that renal lesions might be the consequence of the tuberculosis due to the sedimentation of circulating immune-complexes.

Adult↗
PubMed1992

[Unexpected hypoglycemia in hospitalized patients].

We analyze 40 episodes of unsuspected hypoglycemia (glycemia < or = 3.30 mmol/l) in 36 in patients during seven months in a tertiary hospital. Only 22% of them were diabetics, the rest had other risk-factors such as malnutrition (47%), infections (47%), liver diseases (22%), renal failure (19%) or neoplasias (17%). Only 14% of the subjects had symptoms related to hypoglycemia, and only 27% received treatment. There were no significative differences between those patients over 65 years and the younger ones. Hypoglycemia was not the apparent cause of death in any of the patients, but hospital mortality of these patients was 25%, and it was related with the number of risk factors. We conclude that hypoglycemia in hospitalized patients is often unnoticed, as it appears with diseases other than diabetes, and that it is related with a high mortality in patients with severe diseases.

Aged↗
PubMed1978

Epidemiological, dietary, toxicological and clinical nutrition studies on low-income population groups from a geographical area with endemic chronic arsenic poisoning.

An epidemiological, dietary, toxicological and clinical nutrition study, in an area with endemic chronic arsenic poisoning, was made. In a pilot study on 100 subjects from Antofagasta Commune, water dietary intake was associated with age (r = 0.678; P less than 0.000005). In a dietary survey (N = 220), performed to measure the mean and median arsenic doses, by age groups, there was a significant correlation amongst males (r = 0.800; P = 0.00956) and females (r = -0.791; P = 0.01121). A nutritional assessment of a male population sample (N = 100), of labourers and their children, showed a negative per cent change for food energy in 9 of the 10 age groups, with a maximum negative value of -47.4 (11--12 year-old group), when compared with U.S. recommended daily dietary allowances. For total protein intake, all age groups exhibited a negative per cent change, reaching a maximum value of -27.8 (7--10 year-old group). Since two boys with chronic arsenical dermatosis and prekwashiorkor were drinking water with a mean arsenic concentration of 0.08 and 0.06 ppm, respectively, a maximum permissible concentration of arsenic in drinking water of 0.01 ppm has been recommended as an international safety standard.

Adolescent↗