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J I Arenas

Publications and source records attributed to J I Arenas.

At least 19 recordsLinked to original sources

Fluoxetine.

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Chemical and Drug Induced Liver Injury

Systemic AA amyloidosis induced by oral contraceptive-associated hepatocellular adenoma: a 13-year follow up.

We report a case of a woman who showed hepatic and renal AA amyloidosis with a liver adenoma associated with the use of oral contraceptives. A nephrotic syndrome secondary to the renal amyloidosis underwent complete remission 7 years after the withdrawal of oral contraceptive therapy. Twenty-nine months after the initial presentation, the patient was admitted with acute upper abdominal pain and abdominal tenderness. The abdominal ultrasound revealed a subphrenic fluid collection, and a presumptive diagnosis of a ruptured hepatic adenoma was made. The liver adenoma diminished from 8 cm to 1 cm over a 13-year follow up after the discontinuance of oral contraceptive therapy.

Adenoma, Liver Cell

Antibodies to hepatitis C virus: a cross-sectional study in patients attending a trauma unit or admitted to hospital for elective surgery.

OBJECTIVE: To assess the prevalence of hepatitis C virus (HCV) antibodies in patients attending a trauma unit or admitted to hospital for elective surgery, and to identify risk factors for acquiring HCV infection. DESIGN: A cross-sectional study. SETTING: The emergency room of a Department of Orthopaedic Surgery and a hospital for elective (non-digestive) surgery. PATIENTS: A study population of 1824 subjects (mean age 40.1 +/- 18.1 years) and sera from a control group of 4703 blood donors giving their first donation. INTERVENTIONS: Serum samples were screened for HCV antibodies by second-generation enzyme-linked immunosorbent assays and recombinant immunoblot assays. MAIN OUTCOME MEASURES: HCV serostatus and the relationship between anti-HCV-positivity and age, intravenous drug use, tattoos, blood transfusion, a history of hepatitis and exposure to a contact who had had hepatitis. RESULTS: The overall prevalence of anti-HCV antibodies was 2.85% in the study population and 0.5% among blood donors (chi 2 = 64.5; P < 0.0001). Anti-HCV-positivity was more common in men (3.8 versus 1.9%; P < 0.05) and in subjects with history of hepatitis (13.5 versus 2.0%; P < 0.001), exposure to a contact who had had hepatitis (12.5 versus 1.9%; P < 0.001), blood transfusion (7.8 versus 2.3%; P < 0.001), tattoos (36 versus 2.4%; P < 0.001) and intravenous drug use (85.7 versus 1.9%; P < 0.001). However, one third of subjects had no risk factors for HCV infection. The logistic regression analysis confirmed a statistically significant association (P < 0.05) between anti-HCV-positivity and intravenous drug use, tattoos, blood transfusion, a history of hepatitis and exposure to a contact who had had hepatitis. CONCLUSIONS: These results show almost a five-fold higher prevalence of anti-HCV among patients attending a trauma unit or admitted to hospital for elective surgery than among blood donors.

Adolescent

[Bacterial overgrowth secondary to intestinal diverticulosis].

Jejunal diverticulosis is an unusual finding. We present the case of 70-year-old man with bacterial overgrowth secondary to multiple diverticula of the small intestine. The diagnosis was based on clinical events, x-ray films and mainly on the optimal answer to antibiotic treatment.

Aged

[Esophageal amyloidosis secondary to rheumatoid arthritis simulating achalasia].

The involvement of the esophagus in amyloidosis secondary to rheumatoid arthritis is rare. The case of a female patient with rheumatoid arthritis and secondary esophageal amyloidosis (type AA) with a radiologic and endoscopic clinical picture compatible with achalasia is presented. In the manometry carried out after two cardiomyotomies, abundant non propulsant tertiary waves were seen, as were two primary waves, intraesophageal pressure higher than that of the gastric fundus and lower hypertensive esophageal sphincter which was completely relaxed on one occasion, resulting in a manometric pattern which was different to that of the other two cases published with the same disease. Endoscopic cardiomyotomies and dilatations were performed. The patient died after 2 years due to post dilatation esophageal perforation. The manometric findings are compared with those of the two previous similar cases with emphasis being made in that the anarchic arrangement of the amyloid in the esophagus produces different unforeseen and uncharacteristic motility patterns. The authors only found in the literature two cases of esophageal amyloidosis secondary to rheumatoid arthritis simulating achalasia.

Amyloidosis

Heterosexual transmission of hepatitis C virus and the possible role of coexistent human immunodeficiency virus infection in the index case. A multicentre study of 423 pairings.

OBJECTIVES: To define the role that sexual transmission plays in the spread of hepatitis C virus (HCV) infection, and to examine the influence of coexistent human immunodeficiency virus (HIV) infection on this mode of transmission. DESIGN: A multicentre, seroprevalence study of anti-HCV performed in the stable heterosexual partners (SHP) of index cases reactive for anti-HCV. SETTING: Department of Internal Medicine and Section of Gastroenterology of three University Hospitals, Spain. SUBJECTS: A total of 423 stable heterosexual partners of index cases reactive for anti-HCV. This included a group of 142 intravenous drug users (IVDU), 120 of whom were coinfected with HIV. Additionally, 2886 first-time voluntary blood donors selected at random were included to compare the prevalence of anti-HCV. MAIN OUTCOME MEASURES: Serum samples were screened for anti-HCV by a commercially available, second-generation enzyme-linked immunoassay. Tests repeatedly reactive for anti-HCV were analysed by a four-antigen, recombinant immunoblot assay. Anti-HIV was tested by enzyme immunoassay and Western blot was used for confirmation of positive cases. RESULTS: The prevalence of anti-HCV, was 7.1% in SHP and 1.2% in random donors (P < 0.001). This prevalence was higher in SHP of index cases coinfected with HIV in comparison with that shown in the SHP of index cases only reactive for the anti-HCV (9.1 vs. 6.3%; P = 0.2), particularly when a younger and more homogeneous group such as the SHP of IVDU index cases was considered alone (9.2 vs. 0%; P = 0.1). However, the SHP of IVDU index cases coinfected with HIV were almost three times more likely to be infected with HIV than HCV (24.2 vs. 9.2%). CONCLUSIONS: These data suggest that HCV infection may be sexually transmitted but with low efficiency, and this could be increased in the presence of coexistent HIV infection in the index case.

Adolescent

Intrafamilial spread of hepatitis C virus infection.

We assessed the prevalence of antibodies to hepatitis C virus (anti-HCV) among 401 household contacts of 161 persons with chronic hepatitis C (index patients). None of the index patients had antibodies against HIV. The overall prevalence of anti-HCV was 3.2% (2.5% in the absence of previous parenteral exposure). Sexual partners had a seroprevalence of 4.7% and non-sexual contacts, 2.5%. Among non-sexual contacts, parents showed the highest rate (4.2%). The mean duration of exposure in the anti-HCV-positive sexual partners was 17.3 +/- 8.5 years, vis-à-vis 9.2 +/- 7.4 years in the anti-HCV-negative sexual partners. We conclude that there is little risk of HCV infection through household contact. Although the form of transmission is not well identified, the duration of sexual activity suggests that the time needed to become infected is long.

Adult

[Massive fecal impaction in a patient with osteogenesis imperfecta].

The case of a 22 year old male with massive faecal impaction and anorectal mechanical stenosis caused by multiples bone fractures and pelvic deformities secondary to imperfect osteogenesis is reported. The patient was treated with subtotal colectomy and permanent colostomy.

Adult

[Dubin-Johnson syndrome. Presentation of 3 cases. Review of the national literature].

Three patients, two male and one female, 42, 64 and 20 years old respectively, with a Dubin-Johnson syndrome are reported. Both men referred jaundice since several years and in the woman's case, the onset of the illness took place during the last term of her second pregnancy. In two patients, liver aspect and it's biopsy were diagnostic. In the other, who was hospitalized because of a myocardial infarction, a hepatic gammagraphy with Tc 99 HIDA was made. No case was associated with biliary lithiasis and only one patient had other members in his family with the illness.

Adult

Expression of type 1 blood group precursor in human gastric carcinoma.

The surface epithelium of normal gastric mucosa from patients with gastric adenocarcinoma expressed the type 1 blood group precursor only in Lewis (Le) non-secretor individuals, Le a+b- (se/se, Le/-) and Le a-b- (se/se, le/le). In secretors, the superficial mucosa was negative. Deep areas of the mucosa showed no type 1 precursor regardless of secretor status. Expression of type 1 precursor was anomalously found in neoplastic cells in 14 of 16 Le a-b+ (secretors) patients and in 4 of 5 Le a-b- (secretors) patients. The 1 Le a-b- non-secretor carcinoma expressed type 1 precursor strongly. 6 of 8 Le a+b- non-secretor carcinomas showed positivity for the monoclonal antibody K-21. Thus the type 1 precursor reacted with the non-neoplastic gastric surface of non-secretors but not with those of secretors, and also with most gastric adenocarcinoma regardless of secretor status and Lewis phenotype.

Adenocarcinoma

Lewis system alterations in gastric carcinogenesis.

Alterations in the expression of type 1 blood group-related antigens (Lewis a and b) were examined immunohistochemically in 371 consecutives gastric biopsy and 80 surgical specimens from patients of gastric carcinoma. The ABH and Lewis phenotype and secretor status of the patients were correlated with histologic findings. An anomalous expression of Lewis a antigen was found in 88 of 249 gastric biopsy specimens of Lewis (a-b+) phenotype patients. The prevalence of this anomaly increased with the evolution of the premalignant process, in agreement with the commonly accepted model of gastric carcinogenesis. Thus, anomalous Lewis a antigen appeared in 66.6% of gastric dysplasia cases, in 64.6% of intestinal metaplasia, in 15.4% of atrophic gastritis, and in 7.4% of superficial gastritis. No alterations were found in subjects with normal gastric mucosa. Forty-seven of the 49 Lewis (a-b+) phenotype gastric carcinoma patients showed antigenic alterations in tumor cells (anomalous Lewis a antigen in 36 and loss of Lewis antigens in 11). In 26 of these gastric specimens an anomalous Lewis a antigen was present in areas of intestinal metaplasia and/or dysplasia away from the area of neoplastic transformation. The expression of Lewis a antigen in Lewis (a-b+) phenotype patients is a frequent phenomenon in gastric neoplastic cells and could result from the blocked synthesis of Lewis b antigen with accumulation of its precursors. These findings suggest that, during gastric carcinogenesis, antigenic alterations may precede neoplastic transformation. An anomalous Lewis a antigen could constitute a significant index of severity of the histologic lesion and contribute to identifying high-risk individuals.

Humans