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Biomedical subjects

J Findor

Publications and source records attributed to J Findor.

At least 19 recordsLinked to original sources
PubMed2000

Erythrocytapheresis with recombinant human erythropoietin in hereditary hemochromatosis therapy: a new alternative.

BACKGROUND AND OBJECTIVES: The purposes of this study were to evaluate the tolerance, efficacy and safety of isovolemic erythrocytapheresis (EA) in nonanemic patients with hereditary hemochromatosis (HH), and to assess the usefulness of recombinant human erythropoietin (rHuEPO) associated with EA to reduce treatment duration. MATERIALS AND METHODS: In 10 asymptomatic patients with serum ferritin >400 microg/l, transferrin saturation >50%, and GPT elevation, EA with rHuEPO and folic acid was performed. RESULTS: Red cell indices, serum ferritin, and other iron metabolism parameters (serum iron, transferrin, and transferrin saturation); GPT and other laboratory data were considerably improved. CONCLUSION: This method offers better results in less time than traditional phlebotomy. EA with rHuEPO is an effective therapeutic alternative for patients with HH.

Adult↗
PubMed2000

Methotrexate therapy in primary biliary cirrhosis.

OBJECTIVE: We investigated the effect of low-dose oral MTX in a group of patients with PBC. MATERIAL AND METHODS: Sixteen female with a mean age of 51.16 yrs were included in the present study. Criteria for entry into the trial were elevated serum alkaline phosphatase activity, liver biopsy findings diagnostic of or compatible with PBC, and a positive result for serum mitochondrial antibodies with a title > 1/80. Pts. In cirrhotic stage or jaundice were excluded. Ten pts were symptomatic. Pruritus and fatigue were present in 10 pts. At. Inclusion, 7 (43.75%) presented with histological stage 1.6 (37.5%) stage II and 3 (18.75%) stage III (Scheuer). Control liver biopsy was performed on admission and were repeated at 2 years. All pts were treated with MTX 15 mg/wk given orally in three divided doses over 24 hours during 2 years. For statistical the Kruskal Wallis test was used. RESULTS: Fourteen pts completed 2 years of therapy. Two withdraw from treatment, 1 did so at month 2 due to the worsening of hepatocellular function and development of intense fatigue associated with an elevation of ALT to 30 times over the normal levels and another at month 4 because of interstitial pneumonitis. Pruritus resolved in 5 of the 10 symptomatic patients. All asymptomatic patients remained so during the trial. At the end of the study period, a decline in the following laboratory parameters were observed: Alkaline phosphatase (ALP), from 123 +/- 66 IU/L to 63 +/- 42 IU/L (p = 0.0064); gammaglutamyltransferase (GGT), from 197.3 +/- 121.5 IU/L to 137.2 +/- 56.9 IU/L (p = 0.3352); AST from 47.4 +/- 33 IU/L to 19 +/- 12.4 IU/L (p = 0.0899) and ALT from 54.6 +/- 35 IU/L to 21.12 +/- 5.5 IU/L (p = 0.0771). Liver histology status at the end of MTX therapy improved from baseline in only 3 (18.7%) patients and progression was observed in 8 (50%), to cirrhosis in 4, 3 of them with stage I and another with stage II at the begin of the trial. CONCLUSION: Our results do not support the introduction of MTX as monotherapy in the treatment of PBC. The rapid advance off the disease in some patients during the treatment observed in this cohort of pts merits a word of caution.

Administration, Oral↗
PubMed1999

Pediatric and adult forms of type I autoimmune hepatitis in Argentina: evidence for differential genetic predisposition.

The aim of this study was to compare major histocompatibility complex (MHC) class II susceptibility to type 1 autoimmune hepatitis (AH) between children and adults of the same ethnic group. HLA-DRB1, HLA-DRB3, HLA-DQA1, and HLA-DQB1 gene subtypes were examined by high resolution oligonucleotide typing in 122 pediatric (PAH) and 84 adult (AAH) patients and in 208 controls. In children, HLA-DRB1*1301 was the primary susceptibility allele (66.4% patients vs. 10.6% controls, relative risk [RR] = 16.3, Pc < 10(-24)) whereas HLA-DRB1*1302, which differs from HLA-DRB1*1301 by only 1 amino acid, appeared to be protective. The exclusion of individuals with HLA-DRB1*1301 from control and pediatric patients allowed us to find a secondary association of PAH with HLA-DRB1*0301. Possession of HLA-DRB1*1301, however, was associated with a lower therapeutic response rate. Analysis of peptide binding pocket residues indicated that Tyr 10, Ser 11, Ser 13, and Val 86 in the class II beta chain were present in 85% of patients compared with 37% of controls, suggesting that a high proportion of AH susceptibility is attributable to these residues (etiologic fraction [EF] = 76%). In contrast to the class II associations in children, AAH was associated with HLA-DRB1*0405 (RR = 10.4, Pc <.005) but not with HLA-DRB1*1301 or HLA-DRB1*0301. In addition, HLA-DR4 with the class I gene, HLA-A11, appeared synergistic in predisposing AAH patients to develop extra-hepatic autoimmune (AI) manifestations (odds ratio [OR] = 104.9, Pc < 10(-4)). Concomitant differences in autoantibody profiles were also observed in PAH versus AAH: smooth muscle antibodies (SMA) were most prevalent in PAH but antinuclear antibodies were most prevalent in AAH (P =.003). This study therefore reveals that different HLA-DRB1 allotypes confer susceptibility to AH in children and adults and raises the possibility that PAH and AAH may be triggered by different factors.

Adult↗
PubMed1998

Risk factors for the development of vertebral and total skeleton osteoporosis in patients with primary biliary cirrhosis.

The objectives of this work was to (1) study the bone mineral density (BMD) of the lumbar spine, total skeleton, and body composition in patients with primary biliary cirrhosis (PBC) and (2) evaluate the risk factors (premature menopause, stages of the disease, hyperbilirubinemia) and bone and liver biochemical parameters for the development of osteoporosis. We studied 23 women with a compatible diagnosis of PBC. The BMD and body composition were evaluated by X-ray absorptiometry (Lunar DPX-L). The average age of the population was 56.7 +/- 10.2 years. The BMD of the lumbar spine and of the total skeleton was 1.3 SDs below the normal population matched for sex and age. In the total skeleton, the legs were the most severely affected area (Z score -1.5). The body composition showed no significant difference compared with the normal population. The BMD of 56% of the patients was less than -2.5 SDs from the average normal young values. Patients with a history of vertebral fractures had diminished mineral density of the lumbar spine, as did those who had had no fractures. Of the risk factors studied, patients with premature menopause had a lower bone mass compared with patients with normal menopausal age (Z score of the total skeleton was -2.1 +/- 1.8 versus -1.1 +/- 1.0) but the difference did not reach statistical significance. The bone mass was not affected in patients with regular menstrual cycles. There were no statistically significant differences in high levels of bilirubin, advanced stages of the disease, or the biochemical variables studied. It is concluded that patients with primary biliary cirrhosis present diminished cortical and trabecular bone mass, whereas body composition was unaffected. Premature hormone deficit, possibly triggered by the chronic hepatic pathology, is a contributing factor to the osteoporosis in this population.

Adult↗
PubMed1994

Two-locus involvement in the association of human leukocyte antigen with the extrahepatic manifestations of autoimmune chronic active hepatitis.

We investigated the association of human leukocyte antigen antigens and type 1 chronic active "autoimmune" hepatitis in a population of 65 white Argentinian patients, taking into account the different manifestations of the disease. Standard microlymphocytotoxicity was used for human leukocyte antigen A, B, C, DR and DQ typing. Human leukocyte antigen class 2 alleles were also typed on genomic DNA by means of polymerase chain reaction amplification and hybridization to sequence specific oligonucleotides. A primary association with human leukocyte antigen DR4 was present (human leukocyte antigen DR4: 44% in patients vs. 29% in controls; chi 2, 5.6; p = 0.02, relative risk, 2.1). However, a novel association was observed with human leukocyte antigen A11 (31% in patients vs. 6% in the controls; chi 2, 25.3; corrected p = 0.001; relative risk, 6.8). Moreover, of the 20 human leukocyte antigen A11 patients, 18 had extrahepatic manifestations associated with autoimmune chronic active hepatitis. This represented 60% of the patients bearing this form of the disease (n = 30), conferring a relative risk of 22.2 (chi 2, 46.3; corrected p = 0.00008). In this group, human leukocyte antigen DR3 and DR4 had a weak association. When present together, human leukocyte antigen DR4 and human leukocyte antigen A11 had a synergistic effect, yielding an odds ratio of 357. Statistical analysis and family segregation studies suggest that the two loci products may represent independent risk factors for this form of autoimmune chronic active hepatitis. This synergistic effect was not evident with A11 plus DR3. In autoimmune chronic active hepatitis patients without extrahepatic manifestations, a weak association with human leukocyte antigen DR6 was found.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

A controlled trial of high dose interferon, alone and after prednisone withdrawal, in the treatment of chronic hepatitis B: long term follow up.

This study was designed to evaluate the safety and effectiveness of high dose interferon, with or without prednisone pretreatment, in patients with chronic hepatitis B. Patients were randomised to two treatment groups: group I (n = 26) received six weeks of prednisone followed by a two week, drug free period, and then 10 million units (MU) of interferon alfa-2b three times weekly subcutaneously for 16 weeks; group II (n = 24) were used as controls for 24 weeks and then treated with interferon. Loss of hepatitis B e antigen (HBeAg) and hepatitis B virus (HBV)-DNA, with a return to normal alanine aminotransferase (ALT) activity, was seen in 16 of 26 group I patients (61.5%), in one group II patient (4.2%) during the control phase, and in 13 of 23 group II patients (56.5%) after interferon. Three of 26 (11.5%) in group I and one of 23 (4.3%) in group II eliminated the surface antigen (HBsAg). There were no statistically significant differences in response between groups I and II. Liver biopsies carried out in 20 patients showed that responders had a noticeable reduction in inflammation and disappearance of core antigen in liver tissue, changes not seen in non-responders. On long term follow up (four years), nine out of 28 responders (32.1%) eliminated HBsAg, and four initial non-responders had a late seroconversion.

Alanine Transaminase↗
PubMed1993

Latent distal renal tubular acidosis (dRTA) in primary biliary cirrhosis (PBC) and chronic autoimmune hepatitis (CAH).

In an attempt to evaluate the latent distal renal tubular acidosis (dRTA7) in patients with primary biliary cirrhosis (PBC), and chronic autoimmune hepatitis (CAH), and differences between them in relation to the sodium urinary excretion ([Na]u), thirty four patients divided in two groups were studied. Group A: 17 patients who fulfilled criteria for PBC diagnosis (clinical and humoral evidence antimitochondrial antibody titles of 1/80 or above by indirect immunofluorescence technique, and liver biopsy). Group B: 17 patients who fulfilled criteria for CAH diagnosis (clinical and humoral evidence, antinuclear and smooth muscle antibody titles of 1/80 or above and liver biopsy). Patients with ascitis and/or edema were excluded from the study. Ability to acidify urine was evaluated by gradient between pC02 in urine and blood (U-BpC02) after alkali infusion. Five patients in Group A (29.4%7) and six in Group B(35.2%) had dRTA, (p = 0.49). When analyzing patients with dRTA in both groups, the mean [Na]u in Group A was 152.2 +/- 33.8, versus 50.8 +/- 8.1 mEq/l, in Group B. (p = 0.00016). We concluded that the prevalence of dRTA was similar in patients with PBC and CAH but the urinary acidifications impairment of the former did not correlate with [Na]u, as it did with the latter.

Acidosis, Renal Tubular↗
PubMed1991

[Jaundice caused by methimazole].

Three female patients with cholestatic jaundice related to methimazole therapy are presented. The jaundice appeared after more or less 30 days of therapy. Markers for hepatitis A and B were negative in all. None of them had previous history of alcoholism or ingestion of potentially hepatotoxic drugs. Characteristically there was a marked elevation of alkaline phosphatase and gamma-glutamyltranspeptidase with only moderate increase of the aminotransferases. Liver biopsy performed in all showed intensive cholestasis with low degree of inflammatory reaction confined to the portal tracts. The three patients presented a prolonged duration of the liver injury in spite of the interruption of the drug lasting in one of them up to one year, but all ultimately resolved.

Adult↗
PubMed1988

Primary sclerosing cholangitis.

Thirty patients, 18 males and 12 females, with PSC have been studied between 1972 and 1986. In nine PSC was associated with ulcerative colitis (30%), in 4 with Crohn's disease (13%) and 17 were free of any chronic bowel disease. Four of these 17 were siblings. Alkaline Phosphatase, Gamma GT, total bile acids and 7-alpha-hydroxilated bile acids were elevated in all patients. In 14 patients plasma and urinary copper as well as ceruloplasmin were studied, showing the copper in all cases and ceruloplasmin in 10 cases elevated, 4 were normal. By means of cholangiography alterations of the extrahepatic ducts, the intrahepatic ducts, and both the intra- and extrahepatic ducts were seen in 13%, 27% and 40% of the cases, respectively. Alterations of the pancreatic duct were observed by pancreatography in 21% of cases. 40% of the PSC-patients had also a Sjögren's syndrome, while 3% were associated with diabetes mellitus Type I and II, psoriasis and red lichen planus, iridocyclitis and hepatic hemangioma.

Adult↗
PubMed1982

[Hepatic lesion caused by halogenated anesthetics].

Two patients has been presented to whom general anaesthesia consecutive with halogenated anesthetics has been administrated. In one of the observations the first anaesthesia was administrated with enfluorane and halothane was for the others. The two patients inured with jaundice and in one of them accompanied with hepatic insufficiency; both of them had favourable evolution. The histology of one of them show us a lesion compatible with injury caused by halogenated anaesthesia. In one of the patients appears evidences of hypersensitivity. It is request the possibility that the enfluorane could be acting as a sensibilisant drug of the hepatic injury produced by the halothane. This experience suggest us the danger already described of the consecutive use at short intervals of halogenated anesthetics. So long as fat patients are more sensible to the toxic action of these anesthetics it is suggested prevent in their cases.

Chemical and Drug Induced Liver Injury↗
PubMed1978

The role of the hepatitis B virus infection in patients with chronic hepatitis in Argentina.

Over a seven-year period, we monitored 221 patients with chronic hepatitis from two medical centers. By using the counterlectrophoresis (CEP) test to detect the presence of HBsAg and anti-HBc, or both, we established that 87.7% of them had hepatitis B infection. Serum specimens originally found negative for HBsAg by CEP were further tested by reversed passive hemagglutination (RPH), and those originally found negative for anti-HBc by CEP were further tested by radioimmunoassay (RIA). Five patients were anti-HBc-positive and HBs-Ag-negative. No sex predominance was observed, but HBsAg incidence increased with increasing age. The HBeAg antigen was detected in 46.8% of the 161 cases tested for it; the most frequent subtype found was adw (63.7%). The present findings indicate that HBV infection largely contributes to the development of chronic hepatitis in Argentinian patients.

Adolescent↗
PubMed1975

[The frequency of the e-antigen in acute and chronic hepatitis (author's transl)].

Five groups of patients were studied: (a) 88 HBsAg-positive cases of acute viral hepatitis (AVH) who completely cured within 90 days; (b) 75 cases of acute HBsAg-negative hepatitis with early resolution; (c) 15 AVH patients who became chronic; (d) 94 HBsAg-positive cases of chronic hepatitis (CH) and liver cirrhosis; (e) HBsAg-negative cases with CH. The e-antigen was investigated in every patient and was found in 9 of the AVH cases with favorable evolution, and in 8 of the AVH patients evolving to chronicity. Amont the CH and cirrhosis group, 48 of the HBsAg carriers were positive while e-antigen could not be detected in any of the HBsAg-negative ones. The high incidence of e-antigen carriers among patients with chronic hepatitis and liver cirrhosis as well as among those with AVH who later entered the chronic stage of the disease, deserves especial consideration. A possible role of e-antigen in the evolution to chronicity and a prognostic significance is suggested.

Acute Disease↗