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Biomedical subjects

L Alonso Pulpón

Publications and source records attributed to L Alonso Pulpón.

18 recordsLinked to original sources
PubMed1999

Visceral leishmaniasis (kala-azar) in solid organ transplantation: report of five cases and review.

Visceral leishmaniasis is an infectious disease that occurs only rarely in recipients of solid organ grafts but is associated with an elevated mortality rate despite proper treatment. We report five cases diagnosed in our hospital. All the patients were men aged 30 to 60 years who had undergone kidney transplantation (3 patients), heart transplantation (1), or liver transplantation (1). Three of the patients died, one had multiple recurrences, and one developed post-kala-azar cutaneous leishmaniasis. We review the clinical features, treatments, and outcomes of 26 previously reported cases, pointing out the lower cure rate associated with human immunodeficiency virus infection.

Adult↗
PubMed1998

[Experimental endocarditis. Pathological anatomy of human endocarditis].

Experimental reproduction of human endocarditis in animal models has been based on the induction of structural lesions in valve endocardium using different methods. The primary lesion caused in this way is the so called non-bacterial thrombotic endocarditis. Its colonization is then induced by inoculation of microorganisms in the bloodstream. Freedman's modified method has been the most widespread model of this type. It has mainly been performed in rabbits with inoculation of Staphylococcus aureus or alpha-hemolitic Streptococcus. Experimental models of endocarditis have contributed to our knowledge of the pathogenic mechanisms, causative agents and predisposing factors of endocarditis. They have also allowed us to develop appropriate diagnostic, therapeutic and prophylactic measures for its management.

Animals↗
PubMed1997

[Heart transplantation in a patient with rheumatoid arthritis].

A 56 year-old woman with rheumatoid arthritis was diagnosed with idiopathic dilated cardiomyopathy. She developed progressive heart failure that was refractory to conventional medical management. Heart transplantation was performed bearing in mind the controversy that surrounds its use in patients with a systemic disease. Transplant and rheumatoid arthritis were favorable at 33 month evolution. The immunosuppressive therapy required for the transplant helped the control of her articular disease.

Arthritis, Rheumatoid↗
PubMed1997

[Pneumocystis carinii pneumonia in patients with a solid organ transplant: a report of 5 cases].

A report is made here of five patients who underwent solid organ transplantation, were not infected with the human immunodeficiency virus, and suffered Pneumocystis carinii pneumonia while receiving immunosuppressive drugs. The figure represents a prevalence of 0.43% among patients with solid organ transplantation at the Clínica Puerta de Hierro. Some features of this infection are reported in patients without AIDS, both transplanted patients and with other clinical conditions, the possible predisposing factors and the necessity to keep a high suspect index when individuals treated with immunosuppressive drugs present with respiratory symptoms. Likewise, a suggestion is made to consider the use of chemoprophylaxis with cotrimoxazole in these cases.

Adult↗
PubMed1995

[Heart transplantation].

Heart transplantation is presently the only treatment capable of substantially changing the natural history of endstage heart failure, achieving a 5-year survival rate of 60%. The relative scarcity of available donors is the main limitation to this procedure. The standard surgical technique is that referred to as "orthotopic", described by Shumway and Lower. Research efforts now focus on the design of more efficient methods of preservation that will permit longer storage periods once the grafts have been harvested. Rejection and infection are the most common causes of post-transplantation mortality. The "attenuation" of the immune response to prevent graft loss is achieved by administration of drugs such as cyclosporine A, azathioprine, steroids and antilymphocytic globulins, which constitute the basis for most immunosuppression protocols. Despite numerous proposals of methods for detecting rejection, endomyocardial biopsy continues to be the fastest and most efficient procedure and constitutes a standard tool for monitoring rejection. Graft vascular pathology or chronic rejection is the greatest threat to long-term survival of transplant recipients, 30% of whom are affected by this process after 5 years. Prospects for the future point in three different directions: research to design more powerful and selective immunosuppressive drugs, the development of totally implantable and autonomous artificial ventricular assist systems and the use of xenografts that have undergone genetic manipulations that eliminate interspecies immunological barriers.

Graft Rejection↗
PubMed1994

[Dilated cardiomyopathy in infants and children].

Three cases of dilated cardiomyopathy manifested at 2, 5, and 13 months of age are reported. The clinical, radiographic, electrocardiographic, echocardiographic and angiocardiographic findings are analyzed. The follow up during 11, 14 and 16 years is described. After several years of the onset, 2 patients recovered a normal cardiac function. The third patient required a cardiac transplant when he was 9 years old, and now, after 2 and a half years, he is healthy, without congestive heart failure. Current references about indications of cardiac transplant in this disease are reviewed. We got the following conclusion: In patients with dilated cardiomyopathy, at least in those who begin before 2 years, the indication and the time of the cardiac transplant have to be established by individual valuation of each case, considering the follow up of the risk's criteria, mainly the congestive heart failure.

Cardiomyopathy, Dilated↗