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Biomedical subjects

M Monreal

Publications and source records attributed to M Monreal.

At least 55 records · Page 3Linked to original sources

[Absence of antiDNA antibodies in the cryoglobulins of a case with sicca syndrome (author's transl)].

Cryoglobulins are serum immunoglobulins (immunocomplexes) that precipitate in the cold and redissolve on warming. Cryoglobulins from patients with several diseases showed the presence of antiDNA antibodies when previously underwent incubation in acid buffer. The possibility that antiDNA antibodies might constitute the immunocomplexes found in patients with systemic lupus erythematosus and with other connective tissue diseases is suggested. Negative findings in relation to the presence of antiDNA antibodies in cryoglobulins of a case with sicca syndrome are reported.

Antibodies

Gastroduodenal ulcer incidence in patients with venous thromboembolism.

The presence of peptic ulcer disease implies a high risk of bleeding in patients on heparin therapy. We reviewed our experience with 166 consecutive patients admitted because of venous thromboembolism. Of these 166 patients, 29 were referred for upper gastrointestinal endoscopy in order to detect the presence of any lesion that might contraindicate heparin therapy. A gastric ulcer was found in 10 patients, a duodenal ulcer in 11, and gastric erosions with signs of bleeding in 3 patients. Given the unexpectedly high frequency of ulcer in these patients, an upper gastrointestinal endoscopy was routinely performed early in the course of admission in 50 consecutive patients with venous thromboembolism. A gastric ulcer was found in 5 patients (10%), a duodenal ulcer in 7 (14%), and erosions in 2. Five of these patients had an unsuspected ulcer. A case can be made for prophylactic antiulcer therapy for all patients placed on anticoagulants for venous thromboembolism. Upper gastrointestinal endoscopy is indicated in patients with ulcer symptoms, in those with a previous history of peptic ulcer disease, and perhaps, in patients developing occult blood in the stools while on treatment with anticoagulants.

Adult

[The renin-angiotensin system and anterior pituitary function: endocrine interaction or paracrine modulation?].

The identification of elements of the renin-angiotensin system and ulterior demonstration of specific cellular angiotensin II (Ag II) receptors at hypothalamic-pituitary level has suggested the possibility that these peptide play a modulatory role on anterior pituitary secretion. Recent "in vivo" and "in vitro" studies provided confirmation of a stimulatory effect of the renin-angiotensin system on growth hormone (GH) and ACTH variable. Initial experiments indicate that there is no effect on TSH and gonadotrophins secretion. Treatment with angiotensin-converting enzyme inhibitors leads to a reduction of Ag II levels that results in slight decrease of PRL and GH concentrations. However, the mechanism by which Ag II is able to modulate anterior pituitary secretion still remains obscure. Both, indirect effects mediated through changes in neuropeptide secretion or a direct interaction on pituitary cells by a paracrine or endocrine mechanism emerge as possible hypothesis to explain this regulatory function.

Adrenocorticotropic Hormone

[Clinical usefulness of the glucagon test in the study of pancreatic islet cell function].

In an attempt to assess the utility of glucagon test as an index of beta cell function, we have studied the C-Peptide response to intravenous injection of 1 mg of glucagon in 77 patients with type I diabetes, 27 type II diabetics and 14 normal subjects. A significant difference between basal and glucagon-stimulated C-Peptide levels as well as a good relationship between both values were observed in all groups (r values 0.91, 0.80 and 0.89 respectively). Both basal and stimulated C-Peptide concentrations showed significant relationship with the body mass index and total cholesterol levels, whereas both parameters were negatively related to insulin requirements in type I diabetic group. Absolute C-Peptide increment was different in all groups, despite it was not related to basal C-Peptide levels. These findings confirm the usefulness of glucagon test as an investigative tool to assess the secretory capacity of beta-cell, suggesting that estimation of C-Peptide increment represents the best parameter to evaluate beta-cell reserve.

Adolescent

Occlusive arterial disease as a form of presentation of homocystinuria.

Homocystinuria was first described in 1962. The disease affects several systems including the eyes, skeletal and nervous and vascular systems. We present the case of a 28-year old woman who presented with a severe occlusive arteriopathy. Screening for the most usual causes of arterial disease in young patients was negative, but a study of aminoaciduria and column chromatography confirmed the diagnosis of B6-responsive homocystinuria. Although it was necessary to amputate her left leg, the patient remains asymptomatic 16 months after B6 therapy was started.

Adult

[Heparin-induced hemorrhage in the treatment of venous thromboembolism].

Retrospective study about the frequency of hemorrhagic complications (258 patients) in the treatment of venous thrombosis and/o pulmonary embolism, with heparin. Heparin was intermittently administered by endovenous way and controlled during the ten first days. Mostly of the big hemorrhages happened between the seventh and the tenth day, in digestive and urinary system mainly.

Hemorrhage

[Compression of the iliac vein and occult neoplasm].

Three cases demonstrating the possible venous system compression by some neoplasias, feigning an nonexistent thrombosis, are presented. Author stands out the fitness of to investigate possible neoplasias in thrombosis without apparent causality.

Adult

Asymptomatic pulmonary embolism in patients with deep vein thrombosis. Is it useful to take a lung scan to rule out this condition?

One hundred and sixteen patients with proximal deep venous thrombosis (DVT) confirmed venographically had perfusion and ventilation lung scans performed 48 hours after admission to assess the incidence of asymptomatic pulmonary embolism (PE). Sixty-six patients had normal lung scans, 29 had high-probability defects suggestive of PE, and 21 had indeterminate-probability of PE. Chest X-ray, electrocardiogram and arterial blood gases were of no value in assessing the lung scan results. Six out of 29 patients with a baseline lung scan of high probability of PE experienced acute signs and/or symptoms suggestive of pulmonary embolism while on heparin therapy. A repeated scan this time did not disclose new perfusion defects in any patients. In the absence of a baseline study, these scans may be interpreted as demonstrating pulmonary embolism on treatment and lead to unnecessary caval interruption procedures for failed heparin therapy.

Adult