PubMed Health⌕ Search

Biomedical subjects

J Rodés

Publications and source records attributed to J Rodés.

At least 469 records · Page 26Linked to original sources
PubMed1981

[The role of liver biopsy in the study of patients with fever of unknown origin (author's transl)].

Of 25 patients undergoing percutaneous liver biopsy during the study of fever of unknown origin, the histologic examination provided useful diagnostic information in the nine cases (36 %). The liver biopsy had no diagnostic utility in the remaining 16 patients, half of whom had spontaneous resolution of the fever without a diagnosis being established. Liver enlargement or altered liver function tests were more frequent in the group of patients with a diagnostic liver biopsy, but they had no predictive value as it regards finding morphological changes of diagnostic interest. It is concluded that liver biopsy is an useful procedure in the study of patients with fever of unknown origin.

Adult↗
PubMed1981

Effect of angiotensin-II blockade on systemic and hepatic haemodynamics and on the renin-angiotensin-aldosterone system in cirrhosis with ascites.

We have studied the effect of angiotensin-II blockade with saralasin on the cardiovascular and hepatic hemodynamics and on the renin-angiotensin-aldosterone system in fourteen patients with cirrhosis and ascites. Control measurements showed that most of the patients had a low mean arterial pressure, high plasma volume, normal or high cardiac index, low peripheral resistance and high plasma renin activity and aldosterone concentration. The wedged hepatic venous pressure was increased in each patient and the estimated hepatic blood flow was normal in most of them. Overall, saralasin induced a significant reduction of the mean arterial pressure, cardiac index and peripheral resistance. The decrease of the peripheral resistance was greater than that of the cardiac index. Six of the patients developed a marked reduction of the mean arterial pressure with low doses of saralasin (1--2.5 microgram/kg/min), and they had significantly higher plasma renin activity and lower mean arterial pressure than the remaining eight patients who showed a slight or no hypotensive response in spite of infusing saralasin up to a dose of 10 micrograms/kg/min. Overall, the decrease of the mean arterial pressure correlated directly with the baseline values of plasma renin activity. Angiotensin-II blockade induced a significant reduction of the wedged hepatic venous pressure. The hepatic blood flow did not show any significant change. The decrease of the wedged hepatic venous pressure was directly related to the reduction of the mean arterial pressure and also to the control plasma renin activity. Our study indicates that in most patients with cirrhosis, ascites and high plasma renin activity, arterial pressure is maintained by the effect of endogenous angiotensin II on the peripheral vasculature, and we suggest that a pre-existing arterial hypotension secondary to an arteriolar vasodilatation is the cause of renin release in these patients. Our results also show that angiotensin-II blockade is accompanied by a reduction of the post-sinusoidal hepatic vascular resistance.

Aldosterone↗
PubMed1981

Plasma renin activity and urinary sodium excretion as prognostic indicators in nonazotemic cirrhosis with ascites.

Azotemia is an ominous prognostic sign in cirrhosis with ascites. To investigate whether other renal disturbances are also prognostically significant, we studied the renin-aldosterone system and sodium excretion (UNaV) in 75 patients who had nonazotemic cirrhosis with ascites and related these to survival. On the basis of plasma renin activity patients were classified in two groups. Group I included 34 patients with normal renin activity (1.13 +/- 0.69 ng/mL . h) and Group II, 41 patients with high renin activity (7.46 +/- 3.86 ng/mL . h). The two groups differed significantly (p less than 0.001) in plasma aldosterone, UNaV, and wedged hepatic venous pressure but not in clinical features, liver function, glomerular filtration, and renal plasma flow. Patients of Group I lived significantly longer than those of Group II (the 50% survival rates were 28 months and 6 months, respectively). Survival curves obtained after grouping the patients according to UNaV (higher and lower than 10 meq/d) were almost identical to those obtained according to renin activity. The study results indicate that plasma renin activity and UNaV are of prognostic value in nonazotemic cirrhosis with ascites.

Adult↗
PubMed1981

Renal tubular acidosis in primary biliary cirrhosis.

The relationship between renal tubular acidosis (RTA) and copper metabolism has been investigated in a group of 18 patients with primary biliary cirrhosis. RTA, considered when urinary pH remained above 5.4 after an oral load of ammonium chloride of 0.1 g/kg body wt, was found in 6 patients (33%). Plasma copper concentration (PCu) and urinary copper excretion (UCuV) were significantly higher in patients with RTA (PCu = 182.2 micrograms/dl, UCuV = 536.8 micrograms/24 h) than in those without (PCu = 134.2; UCuV = 170.3). Plasma copper concentration and urinary copper excretion correlated with minimal urinary pH achieved after the ammonium chloride load. A higher degree of cholestasis was present in patients with RTA than in those without, and a linear correlation was observed between PCu and UCuV and serum bilirubin. It is concluded that the increased UCuV is related to the cholestasis in primary biliary cirrhosis and that the RTA might be caused by the deposition of copper in the distal renal tubule.

Acidosis, Renal Tubular↗
PubMed1980

[Epidemiology of hepatitis B in hospital personnel (author's transl)].

This is a seroepidemiological study of infection by viral hepatitis type B affecting sanitary personnel in a general hospital with the objective of determining the occupational risk factor in the acquisition of this disease. Of the 791 subjects who participated in the study, 146 (18.5 percent) showed signs of present or past infection due to virus B (HBsAg or anti-HBs positive by RIA). Seropositivity in hospital personnel was significantly higher that observed in the population of 834 volunteer blood donors (12 percent). The greater frequency of signs of infection was observed in those who had frequent contact with blood and its derivates, and in those who had been working more than 5 years in the hospital. The occupational category with the greatest risk of acquisition of this infection is cleaning personnel, followed by physicians and nurses; and the work areas of greatest risk are the blood bank and the laboratory. The results of this epidemiological survey suggest that viral hepatitis acquired before the initiation of the hospital work are not predominantly B, while those acquired during hospital work are predominantly of type B.

Cross Infection↗
PubMed1980

Use of piretanide, a new loop diuretic, in cirrhosis with ascites: relationship between the diuretic response and the plasma aldosterone level.

Twenty patients with cirrhosis and ascites but no renal failure were given piretanide, a new loop diuretic, in order to investigate its efficacy and to relate the diuretic response with the pretreatment plasma aldosterone concentration. Eleven patients responded to piretanide 12 mg/day (equivalent in potency to 80 mg furosemide); there was no response in nine patients. Both groups were similar with regard to liver function, plasma urea, serum creatinine, plasma electrolytes, urine volume, and urine potassium concentration. The basal urinary sodium excretion was significantly higher in those patients who responded (23.6 +/- 5.7 mmol/day vs. 4.3 +/- 1.42 mmol/day; P < 0.01) (M +/- SE). Plasma renin activity (PRA) and plasma aldosterone concentration (PAC) were normal or only slightly increased in patients who responded to piretanide (PRA = 1.22 +/- 0.20 ng/ml/h; PAC = 12.25 +/- 2.20 ng/100 ml) and very high in patients who did not respond (PRA = 8.71 +/- 1.18 ng/ml/h; PAC = 84.6 +/- 16.2 ng/100 ml) (P < 0.001). Patients unresponsive to piretanide 12 mg/day also failed to respond when the dose was increased to 24 mg/day. However, the addition of spironolactone, 150 mg/day, to piretanide was followed in these patients by a marked increase in diuresis and natriuresis. These results strongly suggest that the pre-treatment level of aldosterone is an important factor influencing the response to loop diuretics in patients with non-azotaemic cirrhosis and ascites.

Adult↗
PubMed1980

Clinical pattern and course of disease in primary biliary cirrhosis based on an analysis of 236 patients.

A prospective study of the clinical pattern and course of primary biliary cirrhosis based on the data of 236 patients (211 females, 25 males) in an international randomized trial has been performed mainly using life-table technique. The median follow-up period has been 18 mo. After the entry into the study, at which time the median duration of symptoms was 2.1 yr, the estimated 5-yr increase in the cumulative percentage of patients was for pruritus from 75% to 95%, jaundice 59% to 82%, hepatomegaly 54% to 86%, pigmentation 54% to 85%, xanthomas 27% to 50%, GI bleeding 17% to 46%, ascites 7% to 49%, and vertebral collapse 3% to 20%. The frequency of cirrhosis increased from 30% to 82% in 4 yr. The mitochondrial antibody titer showed a high rate of progression with time. In analysis of subgroups, age, histologic stage, and particularly the serum bilirubin level were important prognostic factors. Sex, duration of symptoms, and character of first symptom or sign had no independent prognostic influence. The most important indication of seriously progressive course was rapid development of severe cholestasis independent of the histologic stage.

Adult↗
PubMed1979

[Treatment of the syndrome of inappropriate antidiuretic hormone secretion with demethylchlortetracycline (author's transl)].

A patient with a syndrome of inappropriate antidiuretic hormone secretion secondary to an undifferentiated bronchogenic carcinoma with distant metastases was treated with demethylchlortetracycline. Up until recently, treatment of this syndrome was based on water restriction and when the plasma sodium concentration became extremely low, hypertonic saline solution administration. Recently it has been demonstrated that the antibiotic demethylchlortetracycline inhibits the action of the antidiuretic hormone on the renal tubules. The drug has been used successfully in five patients with the syndrome of inappropriate antidiuretic hormone secretion. The administration of 900 mg of demethylchlortetracycline per day for 7 days in our patient produced an increase of free water clearance, diuresis, plasma sodium concentration, and plasma osmolarity. Urinary excretion of sodium and urinary osmolarity declined. Furthermore, the neurological symptoms attributed to hyponatremia improved markedly. The patient lost 6 kg during treatment, probably because of negative water balance induced by demethylchlortetracycline. Even though the administration of demethylchlortetracycline did not produce significant decreases in the glomerular filtration rate or renal blood flow in our patient, it is advisable to control the renal function in individuals treated with this drug since it may on occasion determine renal insufficiency.

Carcinoma, Bronchogenic↗
PubMed1979

Primary biliary cirrhosis associated with HLA-DRw3.

Twenty-one unrelated Caucasian patients with Primary Biliary Cirrhosis were typed for HLA-A, B, C and HLA-DRw antigens. The antigens HLA-Al, HLA-B8 and HLA-DRw3 were found in increased frequency in relation to the control group. When the P values were corrected for the number of antigens tested only the increase of HLA-DRw3 remained significantly different from the control group (P crr. < 0.004). The antigen HLA-DRw3 was carried by 12 out of 21 patients (57.1%) in comparison to 11 out of 74 (14.8%) normal unrelated Caucasian subjects.

Autoimmune Diseases↗
PubMed1978

Esophageal tamponade for bleeding varices. Controlled trial between the Sengstaken-Blakemore tube and the Linton-Nachlas tube.

To investigate the effectiveness and safety of the Sengstaken-Blakemore (SB) tube compared with the Linton-Nachlas (LN) tube, a randomized clinical trial was carried out between both types of balloon. Seventy-nine patients suffering from gastrointestinal bleeding attributed to esophagogastric varices were included in the study. Both types of esophageal tamponade showed great effectiveness in obtaining primary hemostasis (86%), but when the bleeding was from esophageal varices, the SB tube achieved permanent hemostasis more frequently (52%) than did the LN tube (30%). In bleeding gastric varices the SB tube failed in all of the cases, but primary hemostasis was obtained with the LN tube in 50% of them. Better tolerance and greater effectiveness were obtained when the SB tube was applied without external traction. The usefulness of esophageal tamponade for bleeding varices was higher when performed within 6 hr of the onset of hemorrhage.

Esophageal and Gastric Varices↗
PubMed1978

Incidence and clinical significance of sinusoidal dilatation in liver biopsies.

In a review of 906 consecutive liver biopsies, sinusoidal dilatation, unrelated to passive congestion of the liver, sinusoidal infiltration, or cirrhosis, was found in 26 cases (2.9%). In 21 of them the final diagnosis was a neoplastic or granulomatous disease (tuberculosis, brucellosis, Crohn's disease), but in only half of them was there evidence of neoplastic or granulomatous infiltration of the liver. In the remaining cases, sinusoidal dilatation was either the only histological abnormality or it was associated with nonspecific changes. Although the pathogenesis of sinusoidal ectasia is not known, our findings indicate a definite relationship to the presence of tumor or granulomatous disease in the liver or elsewhere in the body. It is concluded that the finding of sinusoidal dilatation as an isolated histological change in a liver biopsy specimen should prompt the search for a tumor or a disease associated with granulomas.

Adult↗
PubMed1978

Kayser-Fleischer-like ring in a cryptogenic cirrhosis.

A patient with cryptogenic cirrhosis was found to have corneal pigmentation rings indistinguishable from Kayser-Fleischer rings on slit-lamp examination. Although she had hepatic encephalopathy that included confusion, tremor, and slurred speech, diagnosis of Wilson's disease was ruled out because urinary cooper excretion and hepatic copper concentrations were below the range found in symptomatic Wilson's disease. The exact nature of these rings could not be determined, and they were considered as Kayser-Fleischer-like rings.

Aged↗