PubMed Health⌕ Search

Biomedical subjects

J Borrego

Publications and source records attributed to J Borrego.

16 recordsLinked to original sources

A description of how metal pollution occurs in the Tinto-Odiel rias (Huelva-Spain) through the application of cluster analysis.

In the last few decades, the study of space-time distribution and variations of heavy metals in estuaries has been extensively studied as an environmental indicator. In the case described here, the combination of acid water from mines, industrial effluents and sea water plays a determining role in the evolutionary process of the chemical makeup of the water in the estuary of the Tinto and Odiel Rivers, located in the southwest of the Iberian Peninsula. Based on the statistical treatment of the data from the analysis of the water samples from this system, which has been affected by processes of industrial and mining pollution, the 16 variables analyzed can be grouped into two large families. Each family presents high, positive Pearson r values that suggest common origins (fluvial or sea) for the pollutants present in the water analyzed and allow their subsequent contrast through cluster analysis.

Environmental Monitoring↗

Characterization of Spanish grapevine cultivar diversity using sequence-tagged microsatellite site markers.

A broad germplasm bank collection containing most of the autochthonous Spanish grapevine cultivars was analyzed using six sequence-tagged microsatellite site (STMS) loci: VVS2, VVMD5, VVMD7, ssrVrZAG47, ssrVrZAG62, and ssrVrZAG79. The number of alleles obtained ranged from 9 in ssrVrZAG47 to 13 in VVS2, and the observed genotypes per locus varied between 24 (ssrVrZAG47) and 41 (VVSS2). A total of 57 unique genotypes were obtained considering all 6 loci, and 40 varieties presented at least 1 of these specific genotypes. The genotypic combinations for the 6 loci have generated 163 different profiles in the 176 cultivars. Ten pairs of accessions and one group of four Garnacha's cultivars can not be differentiated. The observed heterozygosity varied between 75.6 (VVMD7) and 90.9% (VVMD5), without significant differences from the expected values for any loci. The VVMD5 locus was the most informative, and also showed the highest discrimination power. The cumulative discrimination power for all six loci was practically 1; however, in fact, these STMS loci have differentiated only about 93% of the accessions, probably owing to high relatedness of the plant material. Usefulness of this STMS set for characterization of a Spanish grapevine collection is emphasized, as well as the elaboration of databases with these molecular markers.

Gene Frequency↗

Mesenteric tuberculosis with jejunal infiltration.

A 69-year-old female was admitted to our hospital because of asthenia, anorexia and 20 kg weight loss. An ultrasound study and computerized tomography (CT) imaging revealed a mesenteric mass and laparotomy was performed. The diagnosis was mesenteric tuberculosis with jejunal involvement. This represents an atypical onset of tuberculosis in a non-immunosuppressed patient.

Aged↗

[Platelet antiaggregation and hemorrhagic risk in hemodialysis].

UNLABELLED: Although the efficacy of antiplatelet therapy in the prevention of cardiovascular disease in chronic renal failure is not clearly defined, the improvement in cardiovascular disease outcomes in the general population has resulted in its use in dialysis patients. The hemorrhagic risk of hemodialysis patients treated with anti-platelet agents has not been clarified. Our aim was to evaluate the risk of bleeding in hemodialysis patients treated with antiplatelet agents. We assessed haemorrhagic complications (HC) in 190 haemodialysis patients from May 1998 to August 2000. HC was defined an event that required hospitalization and/or blood product transfusion. We evaluated the bleeding events in the haemodialysis patients treated with antiplatelet agents and compare them to those not receiving this therapy to establish the relative risk of bleeding. Uni- and multivariate analyses were conducted to establish the relationships between the haemorrhagic event and the following variables: age, gender, time on dialysis, dialysis membrane (synthetic or cellulosic), systemic anticoagulation during haemodialysis, anaemia (haematocrit), PTH, urea, dialysis efficacy (Kt/V), hypertension, diabetes, use of erythropoietin and antisecretory gastric agents. RESULTS: 81 (42.6%) were treated with antiplatelet agents. Of the 190 patients, 28 (14.7%) had 36 haemorrhagic events (10.3 episodes/100 patient-years); 31 digestive-tract haemorrhages, 4 intracranial and 1 pulmonary. Twenty (24.7%) of patients treated with antiplatelet agents had 16.2 episodes/100 patient-years and 8 (7.3%) without this therapy had 6 episodes/100 patient-years (p < 0.01). In the multivariate analysis the antiplatelet therapy remained associated with higher probability of having a haemorrhagic complication (OR 3.8; CI 95%: 1.52-9.76, p = 0.004). Older age (OR 1.03; CI 95%: 1-1.06, p = 0.043), anaemia (OR 0.91; CI 95%; 0.84-0.9, p = 0.027) and hypertension (OR 2.99; CI 95%: 1.05-8.48, p = 0.039) remained associated with the risk of bleeding. 88.2% of patients that had a digestive-tract haemorrhage with antiplatelet therapy were receiving an antisecretory agent (histamine H2-receptor antagonist or a proton-pump inhibitor). CONCLUSIONS: 1) dialysis patients with antiplatelet therapy had a higher haemorrhagic risk. The relative risk of bleeding was more than three times that of the dialysis population without antiplatelet therapy, and 2) older age and hypertension were associated with the haemorrhagic risk. Optimal correction of anaemia was associated with less probability of bleeding.

Adult↗

[Percutaneous suprapubic bladder lithotripsy].

The authors present a case of multiple bladder stones in a patient with severe ankylosis of the lower extremities, treated via percutaneous suprapubic approach. The suprapubic tract was created with Teflon-coated dilators and an Amplatz tube and the stones were fragmented with the nephroscope and a pneumatic lithotriptor. The simplicity of the procedure and the ease of the manoeuvre accelerated the stone fragmentation process while avoiding unnecessary trauma of the urethra.

Ankylosis↗

[Vascular complications in renal transplantation].

Between the years 1979 and 1992 we a total of 479 renal transplants (RT) were performed. In 62 patients (12.9%) there were some clinically significant vascular complications. These have consisted of: 10 cases of arterial thrombosis (2%); 10 cases of venous thrombosis (2%); 5 cases of arterial and venous thrombosis (1%); 31 cases of arterial stenosis (6.5%); and 6 cases of acute haemorrhage originated at the vascular anastomosis level (1.2%). In all those cases with arterial or venous thrombosis, or both, it was necessary to perform transplantation. The arterial stenosis cases were treated with antihypertensive agents in 13 patients; with endoluminal percutaneous angioplasty (EPA) in other 13 patients and with surgery in 5. Both arterial stenosis and complications from their treatment resulted in 5 transplantations. In all cases with early post-surgical haemorrhage originated at the vascular anastomosis level, a surgical review and suture of bleeding site was performed. A total of 31 grafts (6.5%) were lost as a result of vascular complications.

Adolescent↗

[Myxoid neurofibroma of the renal sinus].

Presentation of one case of a 7.5 x 6 cm myxoid neurofibroma located in the left renal sinus, which is really exceptional. The finding in a 41-year-old, asymptomatic patient is casual and during a routine follow-up study with ultrasound for a Hodgkin lymphoma with a 9-year remission interval. Computerized axial tomography, intravenous urography and thin-needle puncture-aspiration cytology were performed to investigate its origin. Treatment is surgical and requires nephrectomy of the affected side.

Adult↗

[The double J catheter in the shock wave treatment of kidney calculi].

Review of the literature concerning the use of Double J stents prior to extracorporeal shock were lithotripsy. The advantages and disadvantages of stenting are described together with the marked benefit derived from the pretreatment use of the stent. The authors also try to determine which stones are suitable for preliminary stenting, by noting the degree of stone mass.

Equipment Design↗

[Cyst of the ejaculatory duct].

Presentation of a new case of cyst of the ejaculatory duct, diagnosed in a 49-year-old patient. Unspecific symptomatology, with hemospermia and urethrorrhagia of 6 months evolution. Diagnosis is reached by abdominal and transrectal ultrasound and deferent-vesiculography. Computerized Axial Tomography and Magnetic Nuclear Resonance are performed to document the case and for subsequent follow-up. No other associated malformations are found. Following failure of endoscopic surgery, the original approach, abdominal exeresis is performed with excellent evolution both in the immediate post-operative and at 1-year follow-up. Likely etiology and differential diagnosis from other male pelvic cysts are discussed. List of references on differential diagnosis and published cases in included.

Cysts↗

[Surgical complications in 479 renal transplantations].

Exposition of results obtained from the review of the surgical complications found in a series of 479 renal transplantations performed between 1978 and 1992 in our centre, although some of them lack clinical relevance. There was fluid accumulation in 69 patients, distributed between 31 perirenal haematoma. 17 lymphocele, 13 urinoma, 5 perirenal abscesses and 3 mixed. 27.7% required no action. Frequency of renal rupture was 18 cases, 9 due to acute rejection and 9 to vascular thrombosis. Incidence of urinary obstruction was 4.8% with 5.8% of urinary fistula. With regard to the surgical wound, 9 infections, 7 haematomas, 1 eventration and 1 necrotizing fasciitis were observed. Vascular complications consisted in 10 arterial thrombosis, 10 venous thrombosis, 5 mixed thrombosis and 31 arterial stenosis. Treatment instituted for the various cases, its evolution, and an statistical study of risk factors are illustrated.

Adolescent↗

[Hemodialysis with 2.5 mEq/L of calcium in relative hypoparathyroidism: long-term effects on bone mass].

Low PTH secretion is known to be associated with Adynamic Bone Disease (ABD). Positive balance calcium by CaCO3 or dialysate calcium (DCa) might play a role in the parathyroid gland suppression and a decrease in DCa to 2.5 mEq-l or lower has been proposed. The long-term effect of this procedure on bone mineral density (BMD) has not been established. The aim was to evaluate the effect of lowering dialysate calcium on bone mass in patients with relative hypoparathyroidism. We studied 20 patients with intact PTH below 120 pg/ml, using 3 mEq/l DCa and CaCO3 as sole phosphate binder. Sex: 10M/10F. Age: 57 +/- 13 yrs. Months on dialysis: 40 +/- 29. None of them had previous renal transplantation, parathyroidectomy nor aluminic toxicity. BMD of the lumbar spine was assessed by Quantitative Computed Tomography (QCT). They were randomized in two groups (GI and GII), with similar age, sex, and time on dialysis. There were no difference in BMD, levels of intact PTH, serum calcium, phosphate and AP (Alkaline Phosphatase) GI (n = 11; 5M/6F) was transferred to 2.5 mEq/l DCa and GII (n = 9; 5M/4F) continued using 3 mEq/l. BMD was measured one year later. Calcium, phosphate and AP were measured monthly and PTH every three months. After one year of hemodialysis with 2.5 mEq/l of calcium dialysate, BMD showed a significant reduction. BMD mg/cc Baseline (B): 146.09 +/- 54; Final (F): 125.42 +/- 54 (p < 0.01). Z-score B: 0.13 +/- 1.89; F: -0.68 +/- 1.89 (p < 0.05). GII did no show change. The mean change: GI: -15 +/- 13%, GII: 1.28 +/- 17% (p < 0.05); Z-Score GI: -0.81 +/- 0.92, GII: 0.27 +/- 0.67 (p < 0.01). A separate analysis of BMD in both sexes (GI) revealed a tendency for females to lose more bone mineral than males: F: = 17.12 +/- 7.1%. M: -12.23 +/- 18.6% (ns). GI: PTH and AP increased: PTH B: 38.75 +/- 41; F: 99 +/- 69 (p < 0.01); AP: B: 118.4 +/- 47; F: 152 +/- 38 (p < 0.01). GII: PTH B: 53.8 +/- 28; F: 79 +/- 5 (ns). AP: B: 125.1 +/- 36; F: 138 +/- 38 (ns). The rate of BMD loss inversely correlated with the increase of PTH (r = -0.61, p < 0.01). Serum calcium and phosphate did not change. In GI CaCO3 doses were: B: 332 +/- 261; F: 537 +/- 260 (as grams of element calcium, every three months, p < 0.01). By multiple lineal regression only delta PTH and DCa were predictors of greater BMD loss. In conclusion, the use of 2.5 mEq/l dialysate calcium resulted in: 1) Loss of trabecular vertebral bone mass. 2) Increase in PTH secretion and biochemical markers of bone formation. 3) A greater CaCO3 dose.

Adult↗

[A comparison of phosphorus-chelating effect of calcium carbonate versus calcium acetate before dialysis].

INTRODUCTION: The hyperphosphatemia, hypocalcemia and low calcitriol levels are pathogenic factors for secondary hyperparathyroidism in chronic renal failure. The phosphorus control is essential to prevent secondary hyperparathyroidism. There are not comparatives studies to test the efficacy of control of phosphorus binders in predialysis patients. AIM: To compare the efficacy of calcium carbonate vs calcium acetate as phosphate binder in predialysis patients. MATERIAL AND METHODS: The present study includes 28 patients with chronic renal failure (mean clearance of creatinine 21 ml/min). Patients were separated into two groups: Group 1: (n = 14) received calcium carbonate 2,500 mg/day (1,000 mg of calcium); Group 2: (n = 14) receives calcium acetate 1,000 mg (254 mg of calcium). Calcium and phosphorus were determined every 4 months; i-PTH, alkaline phosphatase and clearance of creatinine were determined every six months. RESULTS: Both groups were comparable regarding age, renal function, calcium, phosphorus, alkaline phosphatase and i-PTH on basal situation and the end of study were not different. The serum calcium increased, not significantly, in the calcium carbonate group (group 1) [from 9.2 to 9.8 mg/dl (p = 0.05)], however it was not modified in the calcium acetate group (group 2). The serum phosphorus decreased significantly (p < 0.05) in both groups, independently of the calcium levels. Alkaline phosphatase and i-PTH not was modified during the study period. CONCLUSIONS: 1) Both calcium carbonate and calcium acetate are similarly effective as phosphate binder. 2) The carbonate group required four fold greater doses of calcium that acetate group. 3) The calcium acetate has less hypercalcemic effect than calcium carbonate.

Acetates↗

[Rhabdomyolysis and acute renal failure secondary to statins].

Statins are competitive inhibitors of hydroxy-methyl-glutaryl coenzyme A (HMG-CoA) reductase and are the most commonly used drugs to treat hyperlipidaemia. Muscle toxicity is an adverse effect reported with a low incidence and rarely associated with acute renal failure due to rhabdomyolysis. We describe two patients with chronic renal failure treated with pravastatin and simvastatin who suffered rhabdomyolysis and acute renal failure. One patient started pravastatin several days after cessation of bezafibrate and developed acute renal failure without needing dialysis. The other was treated with simvastatin three years ago and suffered rhabdomyolysis when renal function was impaired after indomethacin was prescribed for backache. He needed hemodialysis because of acute cardiac failure and died from a respiratory infection while on mechanical ventilation. Myopathy was reversible in both patients. We recommend starting statins with the lower doses in chronic renal failure and monitoring muscle enzymes when renal function changes or when new drugs with potential interactions are prescribed.

Acute Kidney Injury↗

[Beneficial effect of AN69 membranes on anemia in hemodialyzed patients].

UNLABELLED: Biocompatible hemodialysis membranes induce a smaller inflammatory response in hemodialysis patients, and remove a larger amount of higher molecular weight retention products, then cellulose membranes. These phenomena could improve uremic anemia in hemodialysis patients. The objective was to evaluate the effects of biocompatible AN69 membranes on anemia in hemodialysis patients. Twenty-five stable patients undergoing hemodialysis with cuprophane membrane for more than 6 months were studied prospectively. These patients were stratified in 2 groups. Group I (GI): 14 patients switched over to a more biocompatible dialyzer (from cuprophan to AN69) and Group II (GII): 11 patients continued treatment with the same cuprophan membrane. The study lasted 5 months. Baseline hematocrit (%), ferritin (ng/mL), transferrin saturation (%), KTV, PCR (g/kg/day) and dose of erythropoietin (EPO) (UI/week) were measured and were revised monthly. Target hematocrit was 33%-35%. A significant increase of hematocrit became obvious after 2 months in GI without changes in dose of EPO and intensity of dialysis, meanwhile GII remains stable. CONCLUSION: Hemodialysis using AN69 membranes increases hematocrit without modifying intensity of dialysis.

Acrylic Resins↗