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P Comas

Publications and source records attributed to P Comas.

6 recordsLinked to original sources
PubMed1994

Incidence and outcome of hepatitis C virus infection after liver transplantation.

The objective of this study was to determine the incidence and outcome of hepatitis C virus (HCV) infection after liver transplantation (OLT). Fifty-two transplanted patients were studied. Serum samples were examined for antibodies to HCV (anti-HCV) and HCV-RNA by PCR, before and after OLT. Patients were distributed into two groups: group 1 consisted of 24 patients (pretransplant anti-HCV positive) and group 2 consisted of 28 patients (pretransplant anti-HCV negative). One year after OLT, HCV-infected patients were evaluated by liver biopsy. HCV-RNA was detected in 28 of the 52 (53.9%) patients after OLT. Twenty-two patients in group 1 (96%) were reinfected. In group 2, acquired HCV infection was detected in six (21.4%) patients. At 6 and 12 months, one and five of six patients had seroconverted, respectively. Liver biopsy in 23 HCV-infected patients showed chronic hepatitis in 18 (78%) cases (2, chronic persistent hepatitis; 3, chronic lobular hepatitis and 13, chronic active hepatitis). Fourteen of the 23 (60.8%) patients were asymptomatic. Most symptomatic patients had chronic hepatitis with cholestasis. Overall, 18 of 20 cases of chronic hepatitis diagnosed in OLT recipients were HCV related. Mortality beyond 6 months after OLT was slightly higher in the HCV-infected group (P = 0.055). In conclusion, HCV reinfection is almost universal. Acquired HCV infection post-OLT is frequent. HCV-infected patients frequently develop chronic hepatitis. Most chronic hepatitis after transplantation are HCV related.

Adult↗
PubMed1993

[Hepatocellular carcinoma: clinical aspects, diagnosis, and survival in 140 cases].

BACKGROUND: Hepatocellular carcinoma (HCC) constitutes a frequent clinical problem in the follow up of patients with liver cirrhosis. The clinical features and diagnoses and survival in a group of 140 cases of HCC are reviewed. METHODS: All the clinical histories of the patients diagnosed of HCC between 1987 and 1991 in the Unit of Hepatology of the General Hospital of the Vall d'Hebron were retrospectively reviewed. The clinical, analytical, diagnostic, therapeutic and evolutive data were collected. RESULTS: One hundred forty patients (121 males and 19 females) were included. In 92% of the cases the HCC was established on liver cirrhosis in which alcohol was the most frequent etiologic factor. According to the Pugh-Child classification 31% of the patients were in group A, 32.5% in group B and 36.4% in group C. Clinically, diagnosis was carried out in the course of periodic out patient follow up in 21% of the cases. HBsAg was positive in 8.5% of the cases and anti HCV was 55% and in 78% by ELISA 1 and ELISA 2, respectively. Alphafetoprotein (AFP) was greater than 500 ng/dl in 37% of the cases. The treatment received was: surgical resection in 18 cases, liver transplantation in 3, intraarterial chemotherapy in 11 and intratumoral alcoholization in 8. Symptomatic treatment was administered in 71% of the cases. Global mean survival was 4.4 +/- 0.5 months. Mean survival was greater in patients with better liver function and smaller tumor size in the patients surgically treated and in those diagnosed in the periodic controls. CONCLUSIONS: Hepatocellular cancer is normally established in patients with liver cirrhosis. The high prevalence of infection by the hepatitis C virus and the low prevalence by hepatitis B virus is of note. The patients with greater survival were those surgically treated and those diagnosed in periodic controls.

Aged↗
PubMed1990

[Lumbosacral spinal cord infarction. Data from magnetic resonance imaging].

A 77-year old woman and a 61-year old man with lumbosacral spinal cord ischaemic lesions and paraplegia presented with dissociated or partial forms of the lumbar enlargement artery (Adamkiewicz's artery) syndrom. Magnetic resonance imaging (MRI) was performed in both patient with an 0.15 Tesla resistive magnet. A hypersignal on T2-weighted images was present in both cases, which corresponded to the infarction affecting the lumbosacral part of the cord. MRI provided accurate delineation of the lesions and clinicoradiological correlations in both patients. The hypersignal occupied the lumbar cord in case 1 and the conus medullaris in case 2. The clinical signs and location of the lesions seemed to be determined by the different patterns of lumbosacral arterial supply. Since such images could be confused with tumoral images, surgical exploration was carried out in both patients; it failed to demonstrate any tumour or cyst and only showed a pale cord. Surgical cord biopsy in case 2 demonstrated ischaemic tissue. We conclude that ischaemia of the spinal cord can be demonstrated by MRI, but owing to the low specificity of this imaging method aedema cannot be distinguished from necrosis, gliosis or demyelination.

Aged↗