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Biomedical subjects

J Almirall

Publications and source records attributed to J Almirall.

At least 73 records · Page 4Linked to original sources
PubMed1990

[Subacute kidney insufficiency in exclusively vascular kidney amyloidosis].

Two patients are reported with secondary amyloidosis in whom renal biopsy disclosed massive amyloid deposition with exclusively extravascular localization. In one case, autopsy showed selective amyloid deposition in the vessel walls of most examined organs. In both patients, the clinical presentation consisted of subacute renal failure without proteinuria. A possible reduction of renal perfusion, secondary to a depleted blood volume in one case and to pharmacological inhibition of prostaglandin synthesis in the other, could enhance renal dysfunction in both patients, who, on the other hand, previously had mild renal failure. The clinical presentation of renal amyloidosis basically depends on the distribution and severity of amyloid deposits. Vascular localization represents an uncommon pattern of renal amyloidosis, generally associated with chronic renal failure with minimal or no proteinuria.

Acute Kidney Injury↗
PubMed1990

Treatment of hyperkalaemia in renal failure with salbutamol inhalation.

The aim of this study was to investigate whether beta-2-adrenergic stimulation with inhaled salbutamol is therapeutically useful in hyperkalaemia. Ten patients with renal failure and hyperkalaemia (serum potassium concentration greater than 6 mmol l-1) were given 15 mg salbutamol via a nebulizer over a 30-min period. Serum potassium was measured 30, 60, 180 and 360 min thereafter. All patients had end-stage renal failure on chronic hospital haemodialysis. Serum potassium levels decreased significantly from a pretreatment value of 6.5 +/- 0.6 mmol l-1 to 5.6 +/- 0.6 mmol-1 after 30 min, and this level was maintained for 3 h. Six hours after treatment, the serum potassium concentration was 6 +/- 0.7 mmol l-1. There was a modest increase in heart rate and blood glucose level, but otherwise salbutamol was well tolerated and no serious side-effects occurred. It is concluded that the administration of salbutamol by inhalation is a simple, safe and reasonably effective method for treatment of hyperkalaemia in renal failure.

Administration, Inhalation↗
PubMed1990

[Uremic hemolytic syndrome induced by mitomycin C. Presentation of a series of 5 cases and review of the literature].

Five new cases of hemolytic uremic syndrome associated mitomycin C treatment in neoplastic patients are presented and clinical, biological, histological therapeutic and the evolution data of 92 other cases from the literature are analyzed. The results point out the high incidence of GI adenocarcinomas (65%), its rare appearance with total mitomycin doses below 50 mg/m2, its frequent clinical presentation with cardiovascular manifestations, the therapeutical difficulties and the possibility of a better prognosis with an early diagnosis.

Adenocarcinoma↗
PubMed1989

[Immediate and 1-year survival after cardiopulmonary resuscitation at an intensive care unit].

Eighty consecutive patients requiring cardiopulmonary resuscitation (CPR) for cardiorespiratory arrest (CRA) were prospectively studied. The immediate survival rate and the survival rates after 48 hours, at the time of hospital discharge and one year later were evaluated. Forty-one patients (51%) initially recovered from CRA, 20 died in the hospital and 17 (21% of the initial group) survived after one year. Survival was related to: 1) the mechanism of CRA. Ventricular tachycardia-fibrillation (VT-VF) had a better prognosis than asystole (AS) and electromechanical dissociation (EMD) (p less than 0.005). 2) Duration of CPR. The survival was higher when CPR lasted for less than 15 minutes (p less than 0.001). 3) Underlying disease. The classification of the patients in three categories depending on the underlying condition permitted an approach to the prognosis of CPR. Group A: patients who did not benefit from CPR, without survivors at the time of hospital discharge. Group B: patients who had a benefit from CPR, with a 37% survival at the time of hospital discharge and 33% after one year, with a good quality of life and a good neurological status. Group C: patients in whom the benefit of CPR was variable, with a similar survival rate as group B at the time of discharge, but with a reduction to 20% in the subsequent year.

Adolescent↗
PubMed1989

[Carcinoma of the kidney as a complication of acquired cystic disease of the kidney in patients subjected to treatment with periodical hemodialysis].

Three cases of acquired cystic renal disease (ACRE) are reported in patients treated with periodical hemodialysis (HD) who developed neoplastic degeneration. In the first patient, diagnosis was a chance finding of nephrectomy during renal transplantation. The second patient was discovered following hematuria, and in the third patient disseminated metastases were the presenting feature of the disease. The finding of renal tumours associated with ACRE is a well known fact; however, metastatic disease has been infrequently reported. Generally, the denomination "adenoma" is adopted for tumours with a maximal diameter shorter than 3 cm, as they seldom develop metastases. However, the third patient had an adenocarcinoma measuring 2 cm in diameter. One of the parameters that best correlates the occurrence of ACRE and tumour development is the duration of HD; therefore, it is suggested that those patients who have received substitution therapy for longer than 3 years should undergo radiological studies for the early identification of these complications.

Adenocarcinoma↗
PubMed1989

Evaluation of culture techniques for identification of catheter-related infection in hemodialysis patients.

A prospective study was conducted over eight months to evaluate the usefulness of two culture techniques using different catheter parts for detection of bacterial colonization or catheter-related bacteremia in patients with jugular or subclavian hemodialysis catheters. A combination of semiquantitative culture of the external surface and quantitative culture of the intraluminal surface of the intradermal catheter segment provided the best means of detecting catheter colonization. For detection of catheter-related bacteremia, this combination had 100% sensitivity and a positive predictive value similar to the actual rate of catheter-related bacteremia.

Bacteria↗
PubMed1989

Electrographic alterations induced by hyperkalaemia simulating acute myocardial infarction.

In general, severe hyperkalaemia produces classic electrocardiographic manifestations including tenting of T waves, widening of the QRS complex, loss of P waves, and eventually, sine waves and asystole. This report concerns a patient with chronic renal failure on maintenance haemodialysis who developed a severe hyperkalaemia associated with chest pain, manifested electrocardiographically by elevation of the S-T segment resembling acute myocardial infarction. After haemodialysis, serum potassium decreased and the electrocardiogram returned to normal. We review the literature and discuss the possible physiology of this electrocardiographic alteration.

Diagnosis, Differential↗
PubMed1989

Infection of hemodialysis catheters: incidence and mechanisms.

Fifty-three consecutive subclavian or jugular hemodialysis catheters inserted into 41 patients were prospectively studied over a period of 8 months in order to determine the incidence of infection and its mechanisms. The intravascular, intradermal and the Y catheter segments as well as both connections were cultured using a quantitative technique for the intraluminal surface. In addition, the intravascular and intradermal portions of the catheter were cultured using a semiquantitative technique for the external surface. Skin smears of the catheter entry site were also cultured, and blood cultures were similarly obtained if fewer developed. Twenty-nine of the 53 catheters (55%) were significantly colonized by one (19 cases) or more (10 cases) microorganisms. The source of the colonizing microorganisms was the skin in 17 cases (58%), intraluminal in 5 (17%), both routes in 5 (17%) and others in 2 (6.8%). Staphylococcus epidermidis (22 cases) and Staphylococcus aureus (4 cases) were the bacteria most frequently isolated. Nine of the 53 catheterizations (17%) were complicated by catheter-related septicemia due to S. aureus in 4 cases, S. epidermidis in 3 cases, Streptococcus faecalis in 1 and Proteus vulgaris in 1. Catheter-related bacteremia contributed to a patient's death in 1 case. Suppurative local infections of the catheter entry site developed in 3 cases, 2 of them with septicemia. We conclude that the rate of infection due to subclavian or jugular hemodialysis catheters is very high and that the skin is the most frequent origin of the microorganisms.

Catheterization, Central Venous↗