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J Bonal

Publications and source records attributed to J Bonal.

At least 19 recordsLinked to original sources
PubMed2007

Obesity, adiponectin and inflammation as predictors of new-onset diabetes mellitus after kidney transplantation.

The high incidence of new-onset diabetes mellitus after transplantation (NODAT) suggests the need to find new factors to explain the pathogenesis. Our objectives were (1) to confirm that low levels of pre-transplant adiponectin are an independent risk factor for the development of NODAT in a larger transplanted population; (2) to analyze whether adiponectin is a better predictor of NODAT than other inflammatory markers (C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha) and pregnancy-associated plasma protein A (PAPP-A)) and (3) to assess the relationship between obesity, inflammatory markers and NODAT. One hundred ninety-nine non-diabetic patients (128 men; age: 53 +/- 11 years; body mass index (BMI) 24.98 +/- 3.76 kg/m2) were included. Pre-transplant plasma glucose, insulin, adiponectin, CRP, TNF-alpha, IL-6 and PAPP-A were measured. Forty-five patients developed NODAT. Patients with NODAT had a greater BMI (p = 0.005). Adiponectin was lower (p < 0.001) and CRP higher (p = 0.032) in patients with NODAT. Multivariate logistic regression and Cox analysis showed that the calcineurin inhibitor used, pre-transplant BMI and adiponectin were predictors of NODAT. ROC analysis showed that an adiponectin concentration of 11.4 microg/mL had a significant negative prediction for NODAT risk (sensitivity: 81% and specificity: 70%). Of the inflammatory markers studied, adiponectin proved to be an independent predictor of NODAT.

Adiponectin↗
PubMed2006

[Compliance with the 2002 consensus document of the Spanish Society of Nephrology for the control of diabetic nephropathy in Catalonia (ECCODIAB)].

OBJECTIVE: To evaluate the level of compliance with the 2002 consensus document (Spanish Society of Nephrology) on guidelines for the detection, prevention and treatment of diabetic nephropathy in Catalonia. SUBJECTS AND METHODS: Multicenter (23 hospitals), observational, cross-sectional, descriptive study conducted in 413 diabetic patients (61.7% men, 38.3% women) with a median age of 66.2 +/-11.5 years (26-93 years). The ANOVA test (post-hoc analysis; p value< 0.05) was used to study the relationships between the stages of diabetic nephropathyand different variables. RESULTS: 90.3% of the patients had type 2 DM. The following anthropometric parameters were observed: BMI 29.8 +/- 5 kg/m2 (BMI > 30 kg/m2: 48.7%) and waist circumference 104.1 +/- 14 cm (48.6% men > 102 cm and 78.9% women > 88 cm). Serum creatinine 1.9 +/- 1.3 mg/dl and simplified MDRD equation 45.3 +/- 25.0 ml/min/1.73 m2 [65.8%with CKD stages 3 and 4]. 80% of patients had ophthalmologic examination and 52.8% antiplatelet treatment. Hb A1c was 7.3 +/- 1.3%, but the percentage of patients with glycated hemoglobin > 7% and 8% was 54.9 and 28.6% [only 50.2% had been seen by an endocrinologist in the last 6 months]. 52.8% of patients were treated with insulin and 44.1% with anti-diabetic drugs, although only 19.6% used the new anti-diabetic drugs. 61% of patients had an LDLc > 100 mg/dl (61% treated) and 44% had triglycerides (TG) > 150 mg/dl (72% treated). 95% of patients presented with hypertension (BP > or = 130/80 mmHg),91% were undergoing antihypertensive treatment (79.7% with angiotensin-converting enzyme inhibitors and / or angiotensin receptor blockers). 81% with microalbuminuria and 78%with established proteinuria were receiving anti-proteinuric treatment. Of the patients considered to be refractory to BP (>3 drugs), only 28.9% underwent ambulatory BP monitoring. Significant differences were observed between stages of diabetic nephropathy and glycated hemoglobin (HBA1c; p = 0.048), systolic blood pressure (SBP; p = 0.024), lipidic control (HDLc; p = 0.015 and TG; p = 0.034), anemia (Hb; p = 0.010) and CKD (creatinine and sMDRD; p = 0.000). The levels of compliance with the therapeutic objectives regarding lipid control (LDL < or = 100 mg/dl and TG< or = 150 mg/dl), BP < or = 130/80 mmHg and HbA1c < or =7% were 1 objective: 68%, 2 objectives: 21.8% and 3 objectives: only 4% of patients. CONCLUSIONS: According to the results of our study, only a reduced proportion of patients fulfilled the different therapeutic end-points indicated. Future measures will be directed at improving physician-patient relationships with the main aim of intensifying the therapeutic measures to attain better metabolic and blood pressure control, nephroprotection and prevention in the appearance of cardiovascular events.

Adult↗
PubMed2006

[Secondary amyloidosis with irreversible acute renal failure caused by visceral leishmaniasis in a patient with AIDS].

We report a case of visceral leishmaniasis and acute renal failure in a white male patient, 28 years of age, infected with the human immunodeficiency virus (HIV). The clinical presentation of the patient was diarrheic syndrome of long evolution, fever, hepatosplenomegaly and pancytopenia, accompanied by nephrotic syndrome and irreversible acute renal failure. Renal biopsy showed glomerular AA amyloid deposits. This is the first case described in humans of secondary amyloidosis caused by visceral leishmaniasis.

AIDS-Related Opportunistic Infections↗
PubMed2004

[Abdominal bruit associated with hypertension].

First cause of secondary hypertension is renovascular hypertension which presents abdominal bruit in 16 to 20% of cases. This clinical sign is also associated with other vascular disease of the abdomen such as celiac trunk stenosis and/or aneurysms located on the pancreaticoduodenal or gastroduodenal arcs level, with little representation among aneurysm. They usually appear on a context of digestive complications like neoplasias, chronic pancreatitis or gastric obstructions possibly with obstructive icterus, hemorrhage and acute abdomen episodes. Its presentation in other contexts is rare and constitutes a diagnostic challenge. Diagnosis is made by abdominal arteriography which is the best method because you can locate the problem as well as intervene therapeutically with embolization of the aneurysme. We would like to emphasize the importance of a quick diagnosis due to the risk of rupture and the high morbi-mortality associated.

Aneurysm↗
PubMed2003

[Infectious endocarditis. A study of 50 patients in a non-university hospital].

The authors report the results of a single centre study of 50 consecutive patients (average age 66 +/- 14 years; 36 men), admitted between 1992 and 2001 to a peripheral hospital for infectious endocarditis (IE). The median interval to diagnosis was 57 days. There was an underlying cardiac disease in 52% of cases, usually valvular (42%). The site of the IE was the mitral valve in 21 cases, the aortic valve in 19 cases, mitro-aortic valves in 5 cases, native tricuspid valves in 2 cases and pacing catheters in 4 cases (associated with valvular endocarditis in one patient). The causal organism was usually a streptococcus (60%, including 28% of streptococcus bovis), or a staphylococcus (22%): no organism could be found in 7 patients. The average follow-up was 33 +/- 30 months: surgery was indicated in half the patients and 3 patients were turned down because of their poor general condition. In all, 34% of patients died (24% of their IE) in a median interval of 6 months, mainly from infectious or haemodynamic complications. Poor prognostic factors were: age > 70 years, "blind" antibiotic therapy, large-sized vegetations, embolism and renal failure. These data, comparable to the results observed in large series in the literature, underline the importance of multi-disciplinary management of IE and strict prophylaxis.

Aged↗
PubMed2003

[Left atrial thrombus in multiple myeloma treated with thalidomide].

The occurrence of a left atrial thrombus without a haemodynamic predisposing factor (arrhythmia, mitral valvulopathy, severe left ventricular dysfunction) is a rare event. We report a case during the progression of refractory myeloma, four months after stopping treatment with thalidomide. The promoting haemodynamic factors for left atrial thrombosis in sinus rhythm, described in the literature, had been excluded. In our case the potential role of thalidomide is debatable, in the light of recent publications about venous and arterial thromboses observed with this treatment.

Aged↗
PubMed2001

Homocysteine and lipid peroxidation in haemodialysis: role of folinic acid and vitamin E.

BACKGROUND: Cardiovascular diseases are the leading cause of death in haemodialysis patients. Hyperhomocysteinaemia is an independent risk factor. Basic research has provided strong evidence that oxidation of low-density lipoprotein (LDL) plays an important role in the pathogenesis of atherosclerosis. Oxidative stress, lipid metabolism alterations, and hyperhomocysteinaemia observed in haemodialysis patients could induce increases in LDL oxidation. This study was designed to determine the effect of folinic acid on hyperhomocysteinaemia and to assess the antioxidant efficacy of folinic acid. The antioxidant effect of folinic acid was compared with that of vitamin E. METHODS: Sixteen stable patients (11 men, five women; mean age 54.3+/-6.32 years) on standard haemodialysis received 400 mg of vitamin E, orally, at the end of each haemodialysis session for 3 months. After a 1-month wash-out, they received 10 mg of folinic acid, intravenously, at the end of each haemodialysis session for an additional 3 months. Blood samples were drawn in the morning after an overnight fast and before dialysis. Plasma vitamin E was analysed by high-pressure liquid chromatography. Malondialdehyde (MDA) was determined using a fluorimetric method and plasma copper oxidized anti-LDL antibodies (Ab-LDLox) were measured with an ELISA method using native LDL and oxLDL as antigens. Plasma homocysteine was determined by an FPIA method. RESULTS: Folinic acid supplements significantly reduced hyperhomocysteinaemia (-44%), MDA concentrations (-40%), and IgG-LDLox titres (-13%). CONCLUSIONS: Treatment with folinic acid lowers plasma homocysteine levels and, like vitamin E, affords antioxidant protection, which prevents lipid peroxidation. This lowering of lipid peroxidation may reduce the risk of atherosclerosis and prevent or delay cardiovascular complications in HD patients.

Antioxidants↗
PubMed2000

[Venous thromboembolism in pregnancy].

A DUAL CHALLENGE: Pregnancy is a physiological state favoring the development of venous thromboembolism and sometimes discloses a coagulation disorder. Due to the presence of the fetus, suspected venous thromboembolism in a pregnant woman raises a dual challenge for the clinician: confirmation of the clinically suspected diagnosis using imaging techniques exposing the fetus to as little radiation as possible, and adapted anticoagulant therapy taking into account the teratogenic risk. MILD TO MODERATE DISEASE: Excepting exceptionally severe cases, the only validated long-term treatment is continuous infusion heparin. However, because of the difficulties inherent in the use and control of this type of administration, most clinicians prefer low-molecular-weight heparins (LMWH) although these pharmaceutical products have not acquired official approval for this indication. PREVENTION: The optimal therapeutic approach for prevention of venous thromboembolism in a pregnant woman with an acquired or hereditary coagulation disorder or a history of venous thromboembolism remains to be defined. New clinical trials are needed to validate the use of LMWH in this indication and determine the therapeutic approach in certain risk situations and at delivery.

Adult↗
PubMed2000

[Inflammatory abdominal aortic aneurysm].

A 58-years-old man, with no medical past history, was examined for abdominal pain and weight loss. An enlarged kidney could be palpated, and abdominal echography showed left hydronephrosis due to ureteral compression by abdominal aortic aneurysm. Laboratory data showed an inflammatory syndrome. CT scan suggested the diagnosis of inflammatory abdominal aortic aneurysm. The use of corticosteroids brought about the regression of the symptoms and the resolution of the ureteral obstruction, permitting aneurysmectomy and prosthesis replacement without ureterolysis. This report shows the interest of preoperative radiological diagnosis of the inflammatory character of abdominal aneurysm. For uncomplicated cases, preoperative treatment using corticosteroids could allow partial regression of the periaortic inflammation and easier surgical repair.

Abdominal Pain↗
PubMed1999

[Post-traumatic vena cava thrombosis].

BACKGROUND: Post-traumatic thrombotic events are exceptional in the caval system. We report a case of inferior vena cava thrombosis in a traffic accident victim. CASE REPORT: A 53-year-old male victim of a traffic accident suffered multiple trauma including blunt trauma of the abdomen. Three months after the accident, the patient was hospitalized with signs of pulmonary embolism proven by angiopneumography. Phlebocavography evidenced a thrombus floating in the inferior vena cava. DISCUSSION: We found 9 other cases of caval thrombus secondary to abdominal trauma in the literature. Tht thrombus usually developed due to endothelial damage secondary to shear forces. Computed tomography of the abdomen with contrast injection contributes greatly to diagnosis. Treatment is a matter of debate due to the prognosis dominated by the risk of massive embolism.

Abdominal Injuries↗
PubMed1999

[Youthful popliteal aneurysm].

Popliteal artery aneurysms are not so clinically frequent but are the most common site of peripheral aneurysms. They usually affect men aged over sixty and are caused by atherosclerosis. Whenever they concern younger men, other more unusual aetiologies such trauma, infection, inflammatory arteritis or popliteal entrapment are responsible. The authors report the first written observation of small size popliteal aneurysm, revealed by intermittent claudication in a 33 years old subject, of which the origin is accelerated atherosclerosis. The evolution after resection of the popliteal aneurysm and end-to-end anastomosis with saphenous vein was favorable. This observation reminds us of various popliteal aneurysm aetiologies, not excluding atherosclerosis due to young age and also underlines that the small size of these aneurysms does not protect against embolism risk.

Adult↗
PubMed1999

[Acute complication of a composite graft replacement of the aortic root].

A 78-year old man operated for an acute aortic dissection 8 years ago was hospitalized for an unusual clinical presentation with acute cor pulmonale and superior vena caval syndrome. He had poorly controlled high blood pressure, and coronary artery disease with aorto-coronary by-pass 10 years ago. He underwent Bentall procedure 2 years later for type I acute aortic dissection, with vein graft reimplantation on the valvular conduit. A pseudoaneurysm was noted in the post-operative period, which remained stable at 45 mm during the follow-up. Thoracic CT-scan highlighted a 14.5 cm diameter pseudoaneurysm compressing the superior vena cava and right pulmonary artery. Detached right aorto-coronary by-pass, suspected on transesophageal echocardiography, was confirmed peri-operatively; the aortic anastomosis blood in the peri-prosthetic space, explaining the acute clinical picture. The severity of the lesions did not permit surgical repair and the patient died during operation. This observation evidences the complications observed after aortic root replacement and favors echographic and radiological follow-ups (J Mal Vasc 1999; 24: 381-383).

Acute Disease↗
PubMed1998

High-performance liquid chromatography analysis of Bobel-24 in biological samples for pharmacokinetic, metabolic and tissue distribution studies.

A rapid and simple HPLC method is described for the determination of Bobel-24 (2,4,6-triiodophenol) and other iodinated derivatives in biological samples. The sample preparation was liquid-liquid extraction before injection onto the HPLC system. 2,6-Diiodo-4-methylphenol was used as internal standard. Separation was obtained using a reversed-phase column under isocratic conditions. The mobile phase consisted of water-acetonitrile (62:38). 2,4,6-Triiodophenol was detected at 277 nm. This method was used for Bobel-24 determination in plasma, urine, synovial liquid and different tissues. The assay was applied to pharmacokinetic studies in dog and horse plasma and different dog tissues for tissue distribution profiles toxicological and metabolic studies. In addition, this method for biological samples can be applied to non-biological samples such as pharmaceutical formulations in stability studies and quality control assays.

Animals↗