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J L Rodríguez-García

Publications and source records attributed to J L Rodríguez-García.

At least 19 recordsLinked to original sources
PubMed1999

Effects of the angiotensin II antagonist losartan on endothelin-1 and norepinephrine plasma levels during cold pressor test in patients with chronic heart failure.

We evaluate the acute hemodynamic and neurohormonal effects of losartan in 15 patients with symptomatic chronic heart failure (CHF), mean age 72+/-8 years, which were classified in two subgroups: (A) Patients with left ventricular ejection fraction (LVEF)< or =0.35 (n = 7); (B) subjects with LVEF>0.35 (n = 8). Sympathetic reactivity (blood pressure, heart rate and plasma norepinephrine) and plasma endothelin-1 (ET-1) were evaluated by a cold pressor test (CPT). Single doses of losartan (50 mg p.o.) lowered delta DBP in both subgroups (A, 8+/-9 to 0+/-5 mm Hg, P<0.05; B, 10+/-6 to 3+/-4 mm Hg, P<0.05) and attenuated the rise of HR in patients with mild (4+/-6 to -1+/-2 bpm, P<0.05) but not with severe (4+/-5 to 2+/-5 bpm, n.s.) impairment of left ventricular function. Losartan blunted the response (delta) of PNE during CPT (A, 142+/-131 to 10+/-74 pg/ml, P<0.05; B, 129+/-72 to 1+/-144 pg/ml, P<0.01). A significant rise in plasma ET-1 was observed during CPT in patients from subgroup B (0.64+/-0.40 to 0.81+/-0.40 fmol/ml, P<0.05) but not in patients with LVEF< or =0.35 (1.79+/-0.44 to 1.51+/-0.66 fmol/ml, n.s.). Losartan attenuated the rise in ET-1 during CPT in patients with LVEF>0.35 (delta ET-1 0.17+/-0.86 to 0.03+/-0.11 fmol/ml, P<0.05), with no significant changes in subgroup A. Acute effects of losartan were characterized by a more favorable hemodynamic and neurohumoral response in patients with chronic heart failure and preserved systolic ventricular function related to subjects with lower ejection fractions.

Aged↗
PubMed1999

Prostacyclin: its pathogenic role in essential hypertension and the class effect of ACE inhibitors on prostaglandin metabolism.

Angiotensin-converting enzyme inhibitors (ACEI) block degradation of bradykinin, and bradykinin stimulates prostacyclin synthesis. Therefore, we set out to determine whether the effects of ACE inhibitors on prostaglandin production in essential hypertensive patients are class effects or are dependent on ACE inhibitor structure. In addition, we studied whether hypertensives show an impaired capacity to synthesize vasodilator prostaglandins. To address these questions, we compared the effects of captopril (sulfhydryl-containing inhibitor), enalapril and ramipril (carboxyl-containing inhibitors) and fosinopril (phosphoryl-containing inhibitor) on blood pressure and urinary excretion of 6-keto-prostaglandin (PG) F1-alpha (the breakdown product of prostacyclin) in 44 mild-to-moderate essential hypertensive subjects before and 8 weeks after administration of an ACEI. We also studied prostacyclin excretion in 15 normotensive healthy controls. Levels of urinary 6-keto-PGF1-alpha (pg/ml) were measured by specific radioimmunoassay. Hypertensive subjects showed a lower excretion of 6-keto-PGF1-alpha than normotensive controls (212+/-147 vs 353+/-98 pg/ml, p < 0.001). All ACEI induced a significant decrease in MAP and increased the rate of excretion of the prostacyclin metabolite: C, 211+/-200 to 338+/-250 pg/ml, p < 0.05; E, 202+/-133 to 296+/-207 pg/ml, p < 0.05; R, 205+/-127 to 342+/-211 pg/ml, p < 0.05; F, 235+/-128 to 347+/-241 pg/ml, p < 0.05. In hypertensives (n = 44) the decrease in blood pressure correlated negatively with the rise in 6-keto-PGF1-alpha excretion (r = -0.51, p < 0.001). These data suggest that impaired prostacyclin biosynthesis in hypertensive patients could account for haemodynamic changes leading to the hypertensive state. Moreover, the hypotensive mechanisms of ACEI may be mediated by an increase in prostacyclin production; this effect seems to be class-dependent.

6-Ketoprostaglandin F1 alpha↗
PubMed1995

Pneumonia caused by Listeria monocytogenes.

Pneumonia due to Listeria monocytogenes is extremely uncommon. We report the case of an 87-year-old woman with no underlying immunosuppressive disease who presented with listerial pneumonia. Cutaneous anergy and a decrease in total lymphocyte count in this elderly woman could predispose her to listerial infection.

Adult↗
PubMed1994

Localized eosinophilic gastroenteritis with necrotizing granulomas presenting as acute abdomen.

Eosinophilic gastroenteritis is a condition of unknown aetiology that has been frequently reported involving the stomach and bowel. The colon is rarely cited as a site for the condition. We report a patient suffering from allergic symptoms (asthma, atopic dermatitis, elevated serum IgE levels) who presented with colonic perforation due to eosinophilic colitis with necrotizing granulomas.

Abdomen, Acute↗
PubMed1994

[The combined treatment of anaplastic thyroid carcinoma].

Five patients with anaplastic thyroid carcinoma (ATC) were treated with chemotherapy (adriamycin 60 mg/m2 and cisplatin 90 mg/m2) followed by surgery and postoperative radiotherapy. The average survival in this series was 11.2 months. Partial response of the cervical tumoration was observed in 4 patients and of the distant metastasis, in 1 of 3 cases. One patient with mixed thyroid carcinoma (follicular and anaplastic) had complete remission of the disease. Four patients died: two due to metastatic disease and two due to local tumor growth. We conclude that this type of combined therapy is affective in patients with anaplastic thyroid carcinoma in terms of local control of the disease, avoiding mortality due to local invasion in some of these patients.

Aged↗
PubMed1992

Magnetic resonance imaging for the assessment of residual masses after treatment of non-Hodgkin's lymphomas.

Eight patients with non-Hodgkin's lymphoma who were in clinical remission but showed residual masses after therapy were examined with magnetic resonance imaging at 1.5 T at the end of therapy, with the sequences TR/TE:500/35,500/70,2000/35 and 2000/70. Residual masses were found in lymphoid areas (7), spleen (3) and kidney (1). In three patients, T2 showed high signal intensity. Disease progressed in the following 1-3 months and active lymphoma was histologically identified. In the other five patients, T2 showed a very low signal intensity. One of them had a distant relapse in lymphoid areas but the remaining four patients are asymptomatic after a mean follow-up time of 13 months, suggesting that the lymphoma is cured and the mass inactive. We conclude that magnetic resonance imaging seems to distinguish active from non-active residual masses after treatment of non-Hodgkin's lymphoma patients otherwise in clinical remission.

Adult↗
PubMed1992

[Value of fine needle aspiration cytology in the diagnosis and treatment of tumors].

UNLABELLED: We report the cytologic results of 186 fine needle aspirations on accessible lymph nodes and tumoral masses as well as deep masses under radiologic control. We assessed the ratios of diagnostic accuracy and the utility of this procedure for staging solid tumors and taking therapeutic decisions. RESULTS: sensitivity, 89.6%; specificity, 100%; positive predictive value, 100%; negative predictive value, 57% and accuracy index, 89.2%. Using this technique we detected a metastatic disease in 62% of neoplastic patients. We took a therapeutic decision (active treatment or analgesia) in accordance with the results of the cytology in 63% of patients with solid tumors. Two patients, after a transthoracic aspiration, developed pneumothorax as a complication. Cytology by fine needle aspiration is a fast and simple method for diagnosing, staging and taking a therapeutic decision on patients with solid tumors.

Adult↗
PubMed1991

Primary sclerosing cholangitis associated with systemic sclerosis.

Primary sclerosing cholangitis is a chronic inflammatory fibrotic disorder strongly associated with inflammatory bowel disease. Although an association between some inflammatory fibrotic conditions, such as Riedel's thyroiditis and retroperitoneal fibrosis and primary sclerosing cholangitis has been described, to our knowledge there are no reports of primary sclerosing cholangitis in patients with systemic sclerosis. A patient with this combination of conditions is presented and the possible significance of the association discussed.

Biliary Tract↗
PubMed1991

Raynaud's phenomenon with digital necrosis as the first manifestation of undifferentiated connective tissue syndrome.

A patient with severe Raynaud's phenomenon (RP) associated with the presence of antibodies against extractable nuclear antigen (ribonucleoprotein) in the context of undifferentiated connective tissue syndrome is presented. The rapid course of digital necrosis in her case resulted in the surgical amputation of 9 of her fingers. We conclude that massive digital necrosis accompanied by severe RP could constitute the first manifestation of a connective tissue disease.

Adult↗
PubMed1991

Recurrent massive pleural effusion as a late complication of radiotherapy in Hodgkin's disease.

We report a very unusual case of a patient with recurrent massive PEs eight years after mediastinal radiotherapy for HD, in which evidence of lymphomatous recurrence could not be demonstrated. The diagnosis of PE as a complication of radiation is presumptive, and other disorders causing PE must be excluded. This condition requires symptomatic treatment and a close follow-up of the patient.

Adult↗