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Biomedical subjects

J L Martín Lorente

Publications and source records attributed to J L Martín Lorente.

16 recordsLinked to original sources

[Good's syndrome and chronic diarrhea].

Good's syndrome is an infrequent disorder associated with humoral immunodeficiency and thymoma. Patients usually present severe or chronic infections. The most frequent are sinopulmonary infections sometimes associated with bronchiectasias. Another complication is chronic diarrhea, frequently associated with malabsorption, which can be due to a mucosal lesion, infection with gastrointestinal pathogens, or bacterial overgrowth. We describe a patient with Good's syndrome and chronic diarrhea due to bacterial overgrowth.

Agammaglobulinemia↗

[The histological lesions of chronic hepatitis C as predicting factors of sustained response to the treatment with interferon].

BACKGROUND: Although many studies have been implemented in order to determine the pre-treatment factors that can predict patients' response to interferon (IFN) therapy, it is not yet clear whether characteristic histologic abnormalities in chronic hepatitis C can predict such response. AIMS: The aim of this study were to evaluate, in patients with chronic hepatitis C, (i) the predictive value of histologic lesions for the sustained response to IFN therapy (ii) other pre-treatment (epidemiological and analytical) factors known to be predictive of response. PATIENTS AND METHODS: Sustained response was retrospectively evaluated in two hundred one patients who had been treated with IFN for at least 3 months in four different hospitals from Castilla y León. The following histological parameters were studied as predictors of response: histological diagnosis, Knodell index, grading and stage, characteristic histologic lesions of HCV infection. Epidemiological and analytical parameters were also evaluated. RESULTS: The rate of patient's sustained response to IFN treatment was 16%. None of the histological parameters was useful to predict this response. By univariate analysis, age, disease evolution time, mode of viral transmission, GGT, ferritin and viral genotype were associated with a sustained response. The most powerful, and only independent predictive factor, however, was the genotype (the response odds ratio was 8.6). CONCLUSIONS: Histological parameters do not predict the response to IFN treatment. Other factors (mainly the viral genotype) are associated with a higher response percentage, although no one is useful to decide which patients are going to respond.

Adult↗

[Sinusoidal portal hypertension secondary to nodular regenerative hyperplasia of the liver].

Regenerative hepatic nodular hyperplasia is infrequent and generally appears in association with many other diseases, the most frequent being the Felty syndrome. It may cause portal hypertension and variceal bleeding. A histologic study is necessary for diagnosis since certain biologic data and the nodular appearance of the hepatic surface may be confused with hepatic cirrhosis from which it may basically be, apart from the histologic features, distinguished by its good prognosis due to the absence of liver failure. We present the case of a seropositive patient with regenerative hepatic nodular hyperplasia and rheumatoid arthritis with marked portal hypertension shown in the hemodynamic study performed by our department for presentation of a persistent elevation in transaminases and ultrasonography alterations suggesting hepatic cirrhosis.

Biopsy↗

[Malignant lymphoproliferative neoplasms and chronic hepatitis C virus infection].

It has been suggested that chronic hepatitis C virus (HCV) infection predisposes to the development of benign and malignant lymphoproliferative disorders. We present 2 cases of malignant lymphoproliferative neoplasias (a non-Hodgkin lymphoma [NHL] and a chronic lymphoid leukemia [CLL]) associated to chronic hepatitis C virus (HCV). The possible etiological role of HCV in the development of these tumors is discussed.

Adult↗

[Alterations in iron metabolism in chronic anti-HCV positive hepatitis. The relationship with response to interferon treatment].

A prospective study in which the existence of iron metabolism alterations (increase in the serum levels of iron and ferritin and the presence of iron in liver tissue) in a group of 53 patients diagnosed with chronic anti-HCV positive hepatitis was performed. The aim of the study was to determine whether these parameters influence the response to interferon treatment. Elevations were observed in the serum levels of iron and/or ferritin in 17 (32%) of the patients. Higher than normal values of serum iron or ferritin in pretreatment analyses were associated with worse therapeutic response. The basal serum levels of iron and ferritin were significantly higher in non responding patients. No relationship was found between the presence of iron in the hepatic parenchyma and response to interferon treatment.

Adolescent↗

[Hepatitis C virus infection and porphyria cutanea tarda].

The prevalence of antibodies versus the hepatitis C virus (antiHCV) was studied in a group of 10 patients diagnosed with porphyria cutanea tarda (PCT) and the possible existence of subclinical forms of PCT was determined in 64 patients with chronic anti HCV positive liver diseases. The prevalence of anti HCV was found to be 40% in patients with PCT. In the group of patients with chronic anti HCV positive liver disease only one patient (1.5%) presented an increase in the urinary elimination of porphyrias in the absence of cutaneous lesions of photosensitivity. This study confirms the importance of the hepatitis C virus as a triggering agent of PCT. These results demonstrate the existence of a low prevalence of subclinical forms of PCT among patients with chronic anti HCV positive liver diseases.

Aged↗

[The usefulness of reactive protein C in managing patients with ulcerative colitis and Crohn's disease].

Serum concentrations of C-Reactive protein (CRP) were measured in 40 patients with inflammatory bowel disease (22 with ulcerative colitis and 18 with Crohn's disease). In the evaluation of disease activity, CRP was a more sensitive (98.6% vs 71.4%) and specific (95% vs 84.6%) activity index in Crohn's disease than in ulcerative colitis. The CRP concentrations were significantly higher in Crohn's disease (57.7 +/- 55.7 mg/dl) than in ulcerative colitis (16.3 +/- 18.8 mg/dl), particularly in severely affected patients (104.8 +/- 54.3 vs 29 +/- 24.2 mg/dl). The CRP levels correlated significantly with clinical activity indices. There was poor or no correlation between CRP levels and the endoscopic activity indices, the extent of inflammatory bowel disease, and the days of hospitalization. We conclude that the determination of CRP levels provide a simple objective index of inflammatory activity with may be useful in the assessment, management and study of inflammatory bowel disease.

Adult↗

[Coagulation changes in inflammatory intestinal disease].

The aim of the present prospective trial was to study the disorders of blood coagulation in 31 patients diagnosed of inflammatory bowel disease (18 with ulcerative colitis and 13 with Crohn's disease) for assessing the possibility of hypercoagulability state in relation to the grade of activity of the disease. During the acute recurrences we observed an increase of factor VIIIC (65.3%), fibrinogen (57.7%), factor VIIIAg (50%), platelet (30.7%) and factor V (19.2%). In two (7.7%) patients a moderate decrease of antithrombin III was detected during a severe episode of activity. During the periods of inactivity the laboratory values concerning the coagulation were normal. There was a correlation between the blood coagulation alterations and the grade of activity of the inflammatory bowel disease.

Adolescent↗

[A psoas abscess in a patient with Crohn's disease].

We report a case of Crohn's disease diagnosed 13 years ago, complicated by a psoas abscess. The main symptoms were flexion deformity of the hip, pain and fever. Diagnosis was made by CT-scan. Surgical and CT-guided percutaneous drainage was ineffective and the abscess relapsed. Surgical resection of the affected bowel with abscess drainage, provided patient's healing.

Adult↗

[Fibro-endoscopic therapy of intraesophageal foreign bodies].

We have studied by means of flexible endoscopy 298 patients with a suspicion of esophageal foreign body. Only a third of them were proven, prevailing in women older than 60 years. We verify the meaning of some symptoms (dysphagia, odynophagia, retrosternal pain, and pharyngeal parestesias) according to the presence or not of the foreign body, and we confirm its general tendency to locate in the proximal esophagus and Killian's ring becoming nailed or impacted in a high percentage (73.8%) of cases. The lesions caused by such foreign bodies were slight in general, and no special treatment was required. The incidence of serious complications was very low (0.97%). The success of treatment by flexible endoscopy was 92.3%, making this the best method for extracting the foreign bodies of the upper digestive tract.

Adult↗

[Treatment with somatostatin of variceal digestive hemorrhage: a one-year prospective].

Twenty-two patients with variceal bleeding were treated with somatostatin, receiving a bolus of 250 mcg followed by an infusion at a rate of 250 mcg/hour. Bleeding stopped in sixteen patients (72.7%). Definitive control was attained in 13 patients (59.2%). Mortality was 31.8%. Somatostatin was not effective in patients with large varices, jet bleeding and hepatic insufficiency. Only minor side effects were recorded in four patients (18.2%).

Adult↗

[Non-variceal upper digestive hemorrhage: evaluation of endoscopic sclerosing treatment].

We appraise the efficacy of endoscopic injection treatment in 112 patients with gastroduodenal bleeding lesion versus 78 control patients (historical group), employing adrenaline (29 patients), absolute ethanol (52 patients) o adrenaline and ethanol (31 patients) as sclerosants. We observe in the treated group a diminution in rebleeding, lower transfusional blood needs and shorter hospital staying, with high stadistic significance versus the control group (p less than 0,001). Among treated patients the larger relapsing index (29.6%) was in patients treated with adrenaline injection only, against the group treated with ethanol or adrenaline and ethanol (10.2%) (p less than 0.05). The demand of surgical treatment was not significant between both groups, except in patients with actively jet bleeding, because urgent treatment was necessary in 37.5% of endoscopically treated patients versus 88.8% in not endoscopically treated. The mortality was similar in both groups.

Aged↗