PubMed Health⌕ Search

Biomedical subjects

J Rigau

Publications and source records attributed to J Rigau.

49 records · Page 3Linked to original sources
PubMed1985

Measurement of azygos venous blood flow in the evaluation of portal hypertension in patients with cirrhosis. Clinical and haemodynamic correlations in 100 patients.

Blood flow in the azygos vein, an index of blood flow through gastro-oesophageal collaterals, was measured by continuous thermal dilution in 100 patients with cirrhosis. Azygos blood flow was directly related to portal pressure (r = 0.54, P less than 0.001). Patients with portal hypertension had very high azygos blood flow (692 +/- 32 ml/min) in comparison with controls (n = 11, 174 +/- 29 ml/min). Patients with previous oesophageal bleeding had similar azygos blood flow as those without, but azygos blood flow was significantly greater in patients with massive or recurrent bleeding than in those with less severe haemorrhage, suggesting that the magnitude of collateral flow may influence the course of variceal bleeding. Patients with grade III varices had higher azygos blood flow than those with grades II or I. In addition, both oesophageal tamponade and vasopressin infusion, procedures of known value in variceal bleeding, markedly reduced azygos blood flow (-40% and -25%, respectively). Measurement of azygos blood flow allows evaluation of haemodynamic changes in the oesophageal collaterals of patients with portal hypertension, and provides useful information on the effect of therapeutic procedures aimed at arresting or preventing variceal haemorrhage.

Azygos Vein↗
PubMedDate not supplied

Effects of propranolol on azygos venous blood flow and hepatic and systemic hemodynamics in cirrhosis.

The effects of propranolol on blood flow through gastroesophageal collaterals and on systemic and hepatic hemodynamics were investigated in 23 cirrhotic patients with portal hypertension. Gastroesophageal collateral blood flow was evaluated by the measurement of azygos venous blood flow by continuous thermal dilution. Azygos venous blood flow was markedly increased in these patients (544 +/- 48 ml per min, as compared with 132 +/- 18 ml per min in subjects without portal hypertension (p less than 0.001). Propranolol at doses achieving effective beta-blockage (83 +/- 5 mg) (mean +/- S.E.M.) markedly reduced azygos venous blood flow (to 354 +/- 34 ml per min, p less than 0.001). Reduction of azygos venous blood flow (-34.2 +/- 3.6%) was significantly greater (p less than 0.01) than reductions in cardiac output (-22.6 +/- 1.9%), hepatic venous pressure gradient (-11.5 +/- 2.4%) and hepatic blood flow (-13.4 +/- 7.4%). The hemodynamic effects of propranolol were not related to plasma norepinephrine levels. Reduction of gastroesophageal collateral blood flow may be the mechanism by which oral propranolol therapy reduces the risk of repeated episodes of variceal bleeding in cirrhotic patients with portal hypertension.

Azygos Vein↗
PubMedDate not supplied

Noninvasive measurement of the pressure of esophageal varices using an endoscopic gauge: comparison with measurements by variceal puncture in patients undergoing endoscopic sclerotherapy.

Measurements of variceal pressure with a noninvasive endoscopic pressure gauge and by direct variceal puncture were performed in 20 cirrhotic patients with portal hypertension in the course of the first session of therapeutic sclerotherapy following an episode of variceal bleeding. Endoscopic gauge measurements of the pressure of esophageal varices gave similar values (15.5 +/- 2.7 mm Hg) than measurements by variceal puncture (15.4 +/- 2.4 mm Hg; not statistically significant), and there was a highly significant linear correlation between both measurements (r = 0.9, p less than 0.001). Azygos blood flow, that was markedly increased in these patients (852 +/- 399 ml per min), was directly related to variceal pressure (r = 0.73, p less than 0.01). Variceal pressure was significantly lower than portal pressure (18.8 +/- 5.0 mm Hg) (p less than 0.05), indicating that measurements of variceal pressure cannot substitute measurements of portal pressure. The study demonstrates that the noninvasive endoscopic gauge technique allows an accurate estimation of variceal pressure in patients with portal hypertension. This technique may provide additional useful information in the evaluation of portal hypertension as well as on the mechanism of variceal bleeding.

Adult↗
PubMedDate not supplied

Effects of metoclopramide and domperidone on azygos venous blood flow in patients with cirrhosis and portal hypertension.

The effects of pharmacological manipulation of the lower esophageal sphincter pressure on the esophageal circulation in patients with cirrhosis and portal hypertension were investigated in 33 patients by measuring the azygos venous blood flow, which is an index of blood flow through esophageal varices and periesophageal collaterals draining into the azygos venous system. Measurements were performed in baseline conditions and after the blind administration of metoclopramide (20 mg i.v.) (12 patients), domperidone (10 mg i.v.) (12 patients) and placebo (9 patients). Both metoclopramide and domperidone caused a significant reduction of azygos blood flow, that decreased by 11.5% (p less than 0.01) and 15.6% (p less than 0.02) respectively, while no change was observed in patients receiving placebo (+1.4%, not statistically significant). Reduction of azygos blood flow represents a selective effect of metoclopramide and domperidone on the esophageal circulation, since portal pressure, hepatic blood flow, cardiac output, heart rate and arterial blood pressure were unchanged by the administration of metoclopramide, domperidone or placebo. These results indicate that the administration of drugs that increase the lower esophageal sphincter pressure may reduce the inflow of blood into the esophageal varices in cirrhotic patients with portal hypertension.

Azygos Vein↗
PubMedDate not supplied

Periocular skin reshaping by CO2 laser coagulation.

When blepharoplasty is performed by transconjunctival route, sometimes the excess of skin created by overlaxness of the lower lid does not retract to achieve the desired cosmetic result. We propose a method for controlled retraction of the eyelid by coagulating the skin using the CO2 laser. Thanks to this approach, the lower eyelid's tone recovers and the desired cosmetic appearance is achieved. Results of 37 patients that were treated by 10 W CO2 laser, 5-mm defocused beam diameter, and pulses of 100 ms, are presented. Follow-up shows that periocular skin reshaping by CO2 laser for laxened eyelid is a safe method and it can be considered a good alternative of treatment for blepharochalasis without skin excision.

Adult↗
PubMedDate not supplied

[Letter on abortion].

Explore the source record for details and available documents.

Abortion, Induced↗