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Biomedical subjects

J Nieto

Publications and source records attributed to J Nieto.

At least 19 recordsLinked to original sources
PubMed1994

Successful therapy for cerebral phaeohyphomycosis due to Dactylaria gallopava in a liver transplant recipient.

A 68-year-old liver transplant recipient who was being treated with FK 506 and immunosuppressive steroid therapy was admitted to our medical center because of a tonic-clonic seizure. Computed tomography of the head revealed multiple discrete cerebral abscesses, and culture of fluid drained intraoperatively yielded a dematiaceous fungus. The isolate was susceptible to amphotericin B and itraconazole but was resistant to flucytosine and fluconazole. The patient was successfully treated with a prolonged course of amphotericin B colloidal dispersion and itraconazole, as evidenced by both clinical and radiographic resolution of disease over a 2-year follow-up.

Aged↗
PubMed1992

Effect of cyclosporin A on proteinuria in patients with Alport's syndrome.

Eight patients with Alport's syndrome and massive proteinuria (129 +/- 60.57 mg/m2 per hour) were treated with cyclosporin A (CyA) for 8 months. The average dose of CyA administered to all patients was 4.21 +/- 0.26 mg/kg per day and blood CyA levels of 63.4 +/- 4.1 ng/ml were attained. In five patients, proteinuria abated during the 3rd week of treatment. In the remaining three, all of whom had low creatinine clearance (82.0, 46.0 and 43.2 ml/min per 1.73 m2 respectively), proteinuria persisted but at levels lower than before treatment: 32.5 +/- 15.9 mg/m2 per hour versus 183.3 +/- 29.7 mg/m2 per hour. No permanent decrease in creatinine clearance was observed in any of these patients throughout treatment. In those patients in whom proteinuria abated, it reappeared 2 weeks after discontinuation of CyA treatment. We observed no significant increases in angiotensin II plasma levels in our patients during CyA administration. Although we have shown that CyA will reduce massive proteinuria in patients with Alport's syndrome, we cannot yet recommend its use as a therapeutic measure.

Adolescent↗
PubMed1988

The effects of chronic chlordiazepoxide administration on ingestion of edible and nonedible substances by rats.

Chronic administration of chlordiazepoxide (CDP) is known to increase feeding in several species and under different procedures. Although this effect does not appear to result from antineophobic and anxiolytic effects of this benzodiazepine, very little is known about the possible contribution of stereotyped nibbling and chewing responses to enhanced feeding. The present study addressed this issue. Experiments 1 and 2 showed that rats injected with 5 and 10 mg/kg CDP spent more time chewing wood than either food-deprived or satiated rats. Experiment 3 showed that rats chronically injected with CDP spent more time chewing biscuits than wood in choice tests; with repeated choice testing chewing biscuits increased while chewing wood decreased. Experiment 4 replicated these results, and ruled out the possibility that increased time chewing resulted only from the self-rewarding effects of chewing. Finally, Experiments 3 and 4 also showed that despite these strong local effects on feeding time, body weight and the amount of food and water ingested every day for 10 days were not increased by 5 and 10 mg/kg CDP. It is unlikely that the effects of CDP on feeding results only from induction of stereotyped nibbling and chewing.

Animals↗
PubMed1988

[Sinocarotid hypersensitivity].

Hypersensitivity of the carotid sinus corresponds to a ventricular pause equal to or exceeding 3 seconds and/or a blood pressure drop equal to or exceeding 50 mmHg, induced by massage of the carotid sinus (MCS). MCS remains the diagnostic method of these two syndromes: cardio-inhibitor/vasodepressor. It must be performed systematically during the work-up of transient consciousness disorders since it is not unusual that hypersensitivity of the carotid sinus may cause cardiac syncopes. In addition, hypersensitivity of the carotid sinus is often associated with sinus dysfunction and atrioventricular conduction disorders. In the case of hypersensitivity of the carotid sinus with syncope secondary to a pure or dominant cardio-inhibiting response, heart stimulation with a dual-chamber pacemaker is probably the best treatment. In cases of hypersensitivity of the carotid sinus without syncope, therapeutic abstention is commonly accepted.

Arrhythmias, Cardiac↗
PubMed1987

Implications of hypervitaminosis A on the calcium-phosphate metabolism and on blood lipids in hemodialysis.

Serum levels of vitamin A (VA) were measured in 71 hemodialysis (HD) patients and in 30 normal controls. 65 of the 71 patients were taking multivitamin preparations (MP) containing VA. The HD patients had significantly greater values: 7.81 +/- 2.86 mumol/l (224 +/- 82 micrograms/dl) versus 3.97 +/- 0.97 mumol/l (114 +/- 28 micrograms/dl; p less than 0.0005); those taking MP with large doses of VA showed the highest levels. Patients were divided as having normal (group I, n = 21) or elevated (group II, n = 50) serum levels of VA. Patients of group II had higher levels of serum calcium (Ca) and lower of serum phosphate (P) and PTH than those of group I. Four months after the withdrawal of oral VA, the serum levels of VA and Ca fell significantly in group II, while the serum P increased. On the contrary, in group I serum levels of VA, Ca and P remained unchanged. Serum triglycerides (TG) were significantly higher in group II but did not change after the withdrawal of VA. No differences between both groups of patients were observed for age, time on HD, residual diuresis, residual renal function, serum levels of cholesterol (CL) or anemia. A retrospective study of 18 hepatic biopsies of HD patients disclosed hyperplasia of Ito cells (VA-storaging cells) in 7 of them. These 7 biopsies belonged to patients who had taken large amounts of oral VA. Our data indicate that prolonged VA intake in HD patients is followed by an increase of serum CA, a decrease of serum P and PTH and a hepatic accumulation of VA.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1987

Improvement of anaemia with desferrioxamine in haemodialysis patients.

We have prospectively investigated the effect of desferrioxamine (DFO) administration (2 gi.v. after every haemodialysis session for 6 months) on the normocytic and normochromic anaemia of seven haemodialysis patients. None had either clinical or analytical data characteristic of chronic aluminium intoxication. At the end of DFO therapy, the haematocrit had increased from 20.5 +/- 2.7% to 30.4 +/- 7.7% (P less than 0.005), and the transfusional requirements decreased from 3.5 +/- 2.2 units (range 1-8 units) in the 6 months prior to DFO, to 0.7 +/- 0.9 units (range 0-2 units) during DFO administration (P less than 0.01). No transfusion was required during the second half of the DFO therapy period. Serum ferritin decreased from 105g +/- 532 nmol/l (2649 +/- 1331 ng/ml) to 507 +/- 403 nmol/l (1268 +/- 1008 ng/ml) (P less than 0.025). Two months after DFO withdrawal the haematocrit value fell significantly to 22.2 +/- 1.6% (P less than 0.01). DFO therapy was restarted in one patient at a lower dose (1 gi.v. after every haemodialysis session) and an increase of haematocrit from 23.8% to 40.2% was again observed after 3 months of treatment. The tolerance to DFO was excellent. We conclude that DFO therapy should be considered in haemodialysis patients with severe anaemia and increased blood transfusion requirements.

Adult↗
PubMed1987

[Efficacy criteria in the fulguration of the bundle of His].

The authors have endeavoured to determine which of the parameters commonly used for His bundle ablation are likely to predict that ablation will be effective in altering the atrioventricular (AV) conduction system durability. His bundle ablation was performed in 18 patients (9 men, 9 women; mean age 47 years) presenting with supraventricular tachycardia refractory to all medical treatments. A total of 29 shocks were delivered with an Odam fulgurator, using a distal electrode connected to the positive pole of a selected catheter. Fifteen shocks were effective, resulting in a complete and permanent AV block (group I); the remaining 14 shocks failed to modify permanently the AV conduction system (group II). The parameters which differed between these two groups were the amplitude and the stability of the His bundle potential, the energy per kg bodyweight delivered with the shock and the possibility to shock the potential with the greatest amplitude in case of instability. A discriminant linear analysis showed that 3 interrelated criteria could be used to classify 83% of the shocks into one or the other group. In order of importance these criteria were: (1) amplitude of the His bundle potential; (2)energy delivered per kg bodyweight, and (3) stability of the potential. The corresponding discriminant values for successful results were more than 300 mV for parameter 1, more than 3 J/kg bodyweight for parameter 2 and very good stability of His bundle potential.

Adult↗
PubMed1986

Unique multimeric pattern of von Willebrand factor in a patient with a benign monoclonal gammopathy.

A 60-yr-old woman had had a bleeding disorder for the last 13 yr, with laboratory features of monoclonal gammopathy and von Willebrand's disease (vWD). There was no evidence of family vWD. She had a prolonged bleeding time, low levels of factor VIII/von Willebrand factor activities and decreased ristocetin-induced platelet agglutination. Platelet von Willebrand factor (vWF) was normal. Plasma vWF showed a unique multimeric pattern with absence of larger and intermediate multimers and a disproportionate increase of the fastest moving multimer with normal satellite bands, thus differing from previously described types of vWF. No evidence for inhibitor, non neutralizing antibody or proteolytic activity against vWF was found in her plasma or IgG fraction. DDAVP response was very poor. We suggest that this patient had a unique, probably acquired, vWD. Nevertheless the possibility of its being a new subtype of congenital vWD associated with an unrelated monoclonal gammopathy cannot be ruled out.

Deamino Arginine Vasopressin↗