PubMed Health⌕ Search

Biomedical subjects

J González

Publications and source records attributed to J González.

At least 19 recordsLinked to original sources
PubMed1992

[Epidemiology, clinical course++, prognosis and treatment of thrombocytopenia associated with human immunodeficiency virus type 1 infection: analysis of 41 cases].

BACKGROUND: Thrombocytopenia is one of the manifestations of infection by the human immunodeficiency virus-1 (HIV-1). A series of 41 patients were studied over a period of 2 years. METHODS: The study was prospectively carried out with a control group of 80 patients with the epidemiology, clinical manifestations, prognosis and treatment of this process being evaluated. RESULTS: The risk groups were: intravenous drug users (IVDU) (78%), homosexuals (12%) and heterosexuals (7%), patients with thrombocytopenia as the only manifestation (group IV-E) constituted the largest group with 30 cases. In 50% of the patients both diseases (thrombocytopenia and HIV infection) were simultaneously diagnosed. Nine patients (22%) vs 35% in the control group evolved to more advanced stages of the infection. Only 39% of the cases had hemorrhagic manifestations being more frequent in the IV-E group (47%) than in the remaining patients (18%). With regards to treatment, only 1 case responded completely with danazol. Steroids had variable, although evaluable, results with minimum secondary effects. The infusion of gammaglobulins achieved 80% of complete, although transitory, responses. Zidovudine obtained a positive response in 17/25 cases. Finally, splenectomy was performed in three patients definitively resolving the thrombocytopenia. CONCLUSIONS: In thrombocytopenia associated with human immunodeficiency virus-1 (HIV-1) infection the distribution by groups of risk is equal to that of the rest of infected patients. Appearing early in the natural history of HIV infection, thrombocytopenia presents few clinical manifestations and does not constitute a factor of bad prognosis. The treatment of choice is zidovudine at doses of 500 mg/day.

Acquired Immunodeficiency Syndrome↗
PubMed1992

[Implantable devices for central venous access in cancer patients. Our experience in 217 cases].

BACKGROUND: The need of having a venous via available for infusion of chemotherapy treatment along with the difficulty of repeated venous access in oncological patients has lead to the ever more frequent placement of central venous access systems (CVAS) implanted into subcutaneous tissue. METHODS: From February 1985 to December 1990 217 CVAS were implanted in 205 oncological patients. Twenty-six were Port-a-Cath and 191 were Implantofix. RESULTS: The average of complications was 0.08/100 days of implantation with an incidence of catheter thrombosis obstruction of 0.03/100 days and system infection of 0.02/100 days. Currently 81 devices continue functioning with 23 having been withdrawn due to complications and 17 for completion of the treatment to which they had been submitted. Ninety-one patients died during this follow up. CONCLUSIONS: The CVAS are devices which are of easy placement, simple handling, requiring minimum care and few complications. Their efficacy is confirmed by the analysis of the data presented in the present study.

Adolescent↗
PubMed1992

Spontaneously diabetic biobreeding rats and impairment of bile acid-independent bile flow and increased biliary bilirubin, calcium and lipid secretion.

Chemically induced diabetes has been reported to induce profound changes in bile formation, but possible toxic effects of the streptozotocin or alloxan used cannot be excluded totally. This study was undertaken to evaluate biliary function in spontaneously diabetic female biobreeding rats with a diabetes duration of 2 wk and compare them with nondiabetic littermates. Diabetic animals evidenced glycosuria, hyperglycemia and hypoinsulinemia. Biliary concentration and secretion of bile acids, cholesterol and phospholipids were significantly increased, with no enhancement in the lithogenic index of bile. Bile flow and the biliary secretion of sodium, potassium, chloride and bicarbonate were significantly reduced despite the increased bile acid secretion. The cholestatic condition was confirmed by an increased serum concentration of bile acids and a higher activity in serum of the alkaline phosphatase liver isoenzyme. Biliary calcium concentration increased without any change in its serum concentration. A linear relationship was observed between biliary calcium and bile acid secretion. Serum concentration of unconjugated and of conjugated bilirubin was increased 1.6-fold and 8-fold, respectively, with a 1.5-fold enhanced biliary secretion of bilirubins despite the cholestasis; this points to an enhanced bilirubin production. An increased proportion of conjugated bilirubin was found in serum together with an enhanced bilirubin diconjugate/monoconjugate ratio in bile. A higher UDP-glucuronyltransferase activity and a delayed transit of bilirubin could account for these effects. Administration of insulin to diabetic animals tended to reverse the above reported changes. The spontaneously diabetic biobreeding rat thus represents a model of bile acid-independent cholestasis with enhanced biliary bile acid and calcium secretion and with presumably an enhanced bilirubin production.

Animals↗
PubMed1992

Malnutrition-related polyunsaturated fatty acid changes in plasma lipid fractions of cirrhotic patients.

Cirrhotic patients have both impaired liver function and nutritional derangement. In fact, the prevalence of protein-energy malnutrition (PEM) is very high in these patients. The aim of the present study was to elucidate whether the nutritional status in cirrhosis could be an additional factor that would affect levels of plasma lipids. Plasma lipid phosphorus, cholesterol, and triglycerides (TG), and fatty acid profiles in plasma and plasma fractions were determined in 50 healthy subjects and 92 patients with liver cirrhosis. The cirrhotic patients were prospectively included in three groups according to the result of nutritional assessment: group 1 (n = 38), acceptable nutritional status (including well-nourished and mildly malnourished patients); group 2 (n = 29), moderate PEM; and group 3 (n = 25), severe PEM. The main findings of this study were that the decrease in plasma cholesterol and linoleic, dihomo-gamma-linolenic, and arachidonic acid levels of cirrhotic patients was related to the degree of PEM. Cholesteryl esters (CE) appeared to be the most sensitive indicator of lipid changes in cirrhosis. We consider that the role of malnutrition in the changes observed for polyunsaturated fatty acid (PUFA) profiles in plasma lipids of cirrhotic patients may be of major importance, since severe malnourished subjects exhibited the lowest levels of those compounds. Dietary supplementation of both essential fatty acids (EFA) and long-chain PUFA in adequate amounts to the cirrhotic patient might be of importance in the management of the disease.

Aged↗
PubMed1992

Testicular 3 beta-hydroxysteroid dehydrogenase/delta 5-4 isomerase in the hypophysectomized rat: effect of treatment with 5 alpha-dihydrotestosterone.

The in-vivo regulatory effect of androgens on steroidogenesis was investigated. Adult (2 to 3 months old) hypophysectomized rats were treated intratesticularly with increasing doses of 5 alpha-dihydrotestosterone (DHT; 10-200 micrograms/100 g body weight) or vehicle (50 microliters dimethyl sulphoxide; DMSO) in the contralateral testis. Intratesticular testosterone concentrations were extremely low in hypophysectomized rats 15-20 days after surgery. Treatment with DHT caused a dose-dependent inhibition of testicular 3 beta-hydroxysteroid dehydrogenase/delta 5-4 isomerase (3 beta-HSD) 2 h later, and this effect was apparent at the dose of 20 micrograms/100 g body weight (P less than 0.01). The inhibitory effect of 3 beta-HSD was not due to a possible interference of DHT in the enzyme assay, since various concentrations of the androgen (0.1-100 mumol/l) were ineffective as inhibitors of 3 beta-HSD. The highest dose of DHT used in this study (200 micrograms/100 g body weight) resulted in a rapid (1-2 h) and transient (4-6 h) inhibition (approximately 80%) of 3 beta-HSD activity. Pretreatment of rats with the antiandrogen cyproterone acetate (5 mg/rat) or the protein synthesis inhibitor cycloheximide (10 mg/rat) did not affect the enzyme activity of testes injected with DMSO, but counteracted the inhibitory effect of DHT on 3 beta-HSD activity in the contralateral testis. The results presented suggest that the inhibitory effect of the non-aromatizable androgen DHT is receptor-mediated and involves the synthesis of a factor(s) that modulates 3 beta-HSD activity.

Androgens↗
PubMed1992

R5020 enhances PGE2 stimulated steroidogenesis in cultured rat granulosa cells.

Progesterone biosynthesis and metabolization to 20 alpha-hydroxyprogesterone was stimulated in granulosa cells cultured in the presence of 20 ng/ml of follicle stimulating hormone (FSH) or increasing concentrations of PGE2 (10(-9)-10(-7)M). Concurrent treatment with the synthetic progestin R5020 (10(-6) M) enhanced the FSH or PGE2 stimulated progesterone and 20 alpha-hydroxyprogesterone accumulation in culture media, as well as delta 5-3 beta-hydroxysteroid dehydrogenase activity in granulosa cell homogenates. These findings may represent another example of an autocrine control mechanism in which the steroidogenic product of the granulosa cell exerts an ultra-short loop regulation of its own production.

20-alpha-Dihydroprogesterone↗
PubMed1992

[Lymphoproliferative syndromes associated with rheumatoid arthritis].

Rheumatoid arthritis predispose to several lymphoproliferative syndromes, some of them are of doubtful neoplastic type, as the lymphoproliferative disease of granular lymphocytes, whereas others are clearly malignant, as non-Hodgkin's lymphomas and multiple myeloma. In this paper, we review the potential etiological agents, mainly the reduction of the "natural killer" activity and immunity disorders against virical oncogenes. The onset of monoclonal gammopathy in rheumatoid patients is also stressed, due to its potential prognosis value in the development of lymphoid neoplasias.

Arthritis, Rheumatoid↗
PubMed1992

[Cancer of the esophagus (II): the results of surgery, anatomicopathological study and patient survival].

We present a retrospective study of 68 esophageal cancer patients treated with surgery between 1975 and 1991. Results showed a resectability of 73.5% with the most frequent surgical approach being a Lewis esophagectomy. The mean hospitalization time was 24.7 days with a postoperative mortality of 7.3%. Other complications included anastomotic leakage, wound infection, sepsis and pulmonary disorders. Over-all survival at 3 years was 17.3%, reaching 24% in resected patients. Survival according to lymph node involvement was 13.4% for lymph node positive patients and 34.5% for node negative patients. According to histopathologic stage, survival rates were 34.6% and 8.59% for early and advanced tumor respectively, the difference being statistically significant using the Mantel-Haenszel test.

Actuarial Analysis↗
PubMed1992

[Acute posttraumatic myocardial infarct: the necessity of an early interventionist posture].

We describe five cases of posttraumatic anterior acute myocardial infarction in young patients, without previous heart disease. One case was treated with intracoronary thrombolysis and angioplasty, 3 cases received systemic thrombolysis, and the last one did not have any re-permeabilization therapy, having arrived to the hospital 72 hours after the episode. The coronary angiograms showed at the left anterior descending artery: thrombosis in 3 cases, coronary dissection in one case, and slow flow with no morphological lesions in the other. The case which not received thrombolytic therapy developed a severe left ventricular dysfunction. In conclusion we emphasize an early angiographic study, in order to decide the re-permeabilization therapy.

Accidents, Traffic↗
PubMed1991

[A multicenter study of the breaking of the smoking habit with nicotine chewing gum in health personnel].

BACKGROUND: The health professionals have a leading role in the reduction of the smoking prevalence. Spain has one of the big rate of "per capita" tobacco consumption in the world, and the Spanish doctors have the biggest prevalence of smokers among their colleagues from the EEC countries. METHODS: The effectiveness of a stop smoking programme in health care professionals was evaluated. This programme combined group therapy, nicotine chewing gum and behavioural assistance through the evaluation of CO contained in expired breath; and it is being applied with good results between the smokers of general population in Spain. A total of 211 voluntary smokers working in Spanish six general hospitals were treated, from those 149 (71%) were physicians and nurses (PS) and 62 (29%) others professionals without sanitary responsibilities (PNA). RESULTS: At one year follow-up, 64 (30%) were not smoking, and the P.S. had a higher rate of give up than the PNA (p less than 0.05). Specifically the women of P.S. obtained a greater issue than the women of PNA (p less than 0.05). Both, nicotine chewing gum and behavioural assistance were as effective as usual in smoking cessation programme like this, in our country. CONCLUSIONS: Although the outcome is lower than the obtained with the same approaches in smokers from general population, the better results of the PS than the PNA imply a good change of attitude of them. Specially the women PS obtained a big success, and this is outstanding in this group with a great prevalence of smokers, increasing in the recent years. The subjects who give up smoking increased their corporal weight less than the observed in smokers of the general population, who also give up with this treatment.

Adult↗
PubMed1991

Interstitial 15q deletion without a classic Prader-Willi phenotype.

We report on a newborn boy with pronounced hypotonia, cryptorchidism, minor facial anomalies, congenital heart defect, neurologic anomaly, deafness, renal anomaly, and bifid uvula. The patient has a de novo proximal interstitial deletion of chromosome 15 reaching to band q14, larger than that usually seen in Prader-Willi and Angelman syndromes.

Chromosome Banding↗