PubMed Health⌕ Search

Biomedical subjects

P Naranjo

Publications and source records attributed to P Naranjo.

At least 19 recordsLinked to original sources
PubMed2001

Incidence of renal artery stenosis in pediatric en bloc and adult single kidney transplants.

BACKGROUND: The incidence, time of onset, and outcome of transplant renal artery stenosis (TRAS) in pediatric en bloc (PT) and adult single-kidney (AT) transplants were reviewed. METHODS: Forty-three cases (7 PT and 36 AT) of suspected TRAS were selected out of 367 functioning grafts (35 of them PT). Diagnosis was performed by digital subtraction arteriography. Percutaneous transluminal angioplasty (PTA) was performed when needed. RESULTS: Seven (20%) PT and 24 (7.1%) AT presented TRAS. Time of onset was 7+/-1 months in PT and 18+/-17 months in AT (P<0.05). PTA was performed in all cases of TRAS in PT and in 19 AT. One PT and 7 AT had re-stenosis. There was no significant difference in renal function after treatment. Control of blood pressure improved in both groups. CONCLUSIONS: Recipients of PT grafts showed a higher incidence and earlier onset of TRAS. Re-stenosis was more frequent in AT.

Adolescent↗
PubMed2000

Influenza virus immunization effectivity in kidney transplant patients subjected to two different triple-drug therapy immunosuppression protocols: mycophenolate versus azathioprine.

BACKGROUND: Due to possible complications and treatment limitations, the prevention of influenza in renal transplant (RT) patients is highly indicated. METHODS: Forty-nine patients with a 1-year functioning RT subjected to two different immunosuppressive regimens and 37 healthy relatives (HR) were administered the anti-influenza vaccine as recommended for 1996 to 1997. Anti-influenza antibody, creatinine, and immunological markers were estimated at 1 and 3 months after vaccination. RESULTS: Three months after vaccination, 46.2% of the RT patients and 69% of the HR (P=0.06) showed protective antibody titers to influenza A (relative risk [RR]; 0.67; 95% confidence interval: 0.44-1.02). A total of 20.5% of the RT patients and 44.8% of the HR showed antibodies to influenza B (P=0.03). Despite these differences, the incidence of illness was similar. The immunosuppressive regimen had no effect on the antibody response. CONCLUSIONS: Although the RT patients showed a reduced antibody response, no negative effects on graft outcome were observed.

Adult↗
PubMed1994

Safety, immunogenicity and protective effect of the SPf66 malaria synthetic vaccine against Plasmodium falciparum infection in a randomized double-blind placebo-controlled field trial in an endemic area of Ecuador.

A total of 537 subjects were randomized to receive either SPf66 malaria vaccine against Plasmodium falciparum or placebo in three doses (days 0, 30 and 180). Subjects completing the course of vaccination (230 in the vaccine and 238 in the placebo group) were followed up for a further 12 months. Case detection surveillance was implemented by parasitological cross-sectional surveys every 2 months and by monthly household visits to each participant. Symptomatic subjects were also diagnosed in a local health centre. Minor local side-effects were observed mainly after the second dose in about 19% of the vaccinated subjects and in 3.7% of the placebo group. Thirty days after the third dose the prevalence of anti-SPf66 antibodies was 57% in the vaccine and 8.8% in the placebo groups. The prevaccination prevalence of antibodies measured by indirect immunofluorescence assay increased with age and seemed to be inversely related to anti-SPf66 antibody production. Immune response to SPf66 was independent of age. Vaccine efficacy was calculated based on person-time of exposure. The protective effect considering any malaria episode was 66.8% (95% confidence interval = -2.7-89.3%) and considering only one episode per individual was 60.2% (95% confidence interval = -26-87.5%).

Adolescent↗
PubMed1991

Treatment of hyperlipemia in diabetic patients on dialysis with a physiological substance.

Hyperlipemia is a very frequent complication of the diabetic patient on dialysis. There is difficulty of treatment with the diet, because the dietary restriction already imposed on these patients and the secondary effects and toxicity of the available drugs in uremics aggravate the problem. We have treated 22 diabetic patients on dialysis (8 on hemodialysis and 14 on continuous ambulatory peritoneal dialysis) suffering from hyperlipemia with pantethine, a physiological substance and coenzyme A precursor in the Krebs cycle. With the administration of an oral dose of 900 mg/day we obtained a reduction of total cholesterol (275 +/- 72 vs. 231 +/- 54 mg/dl; p less than 0.001), very-low-density lipoprotein (VLDL)-cholesterol (66 +/- 36 vs. 46 +/- 18 mg/dl; p less than 0.01) and triglycerides (332 +/- 182 vs. 227 +/- 90 mg/dl; p less than 0.01) at 2 months. High-density lipoprotein (HDL)-cholesterol did not change, but the total cholesterol/HDL-cholesterol ratio decreased significantly (p less than 0.05). Total cholesterol, VLDL and triglycerides showed a progressive and significant reduction at 4 and 6 months. No changes were observed in serum glutamic oxaloacetic transaminase, serum glutamic pyruvic transaminase, uric acid, blood glucose and glycosylated hemoglobin. Gastric discomfort in 2 patients and pruritus in another one were the secondary effects related. Pantethine was shown to be a very effective hypolipemic agent in diabetic patients on dialysis with a great tolerance.

Cholesterol↗
PubMed1991

Peritoneal clearances, protein losses and ultrafiltration in diabetic patients after four years on CAPD.

Peritoneal clearances of urea (C(urea)) and creatinine (Ccr), peritoneal protein losses (PL) and ultrafiltration (UF) were retrospectively evaluated in 12 diabetic patients on continuous ambulatory peritoneal dialysis (CAPD) during a four year study. The average of three determinations each year was calculated. There were not significant differences in C(urea) (ml/24 hours), Ccr (ml/24 hours), PL (g/24 hours) and UF (ml/24 hours) between the four years and basal values or in the year to year studies. Seven patients did not modify their CAPD schedule during the four years study and we did not find any statistical differences in this group in the parameters studied. There was an average incidence of peritonitis of 4.7 episodes, higher in the 2 first years (p less than 0.05). The peritonitis incidence did not affect any of the functional parameters evaluated. The results of our study suggest that C(urea), Ccr, PL and UF in diabetic patients are not affected by long-term CAPD or by the peritonitis incidence.

Creatinine↗
PubMed1989

[Morbidity and mortality of diabetic patients on dialysis in a 10-year program: value of combined treatment].

Morbidity and mortality derived from the employed techniques after ten year experience in treating patients afflicted with end-stage diabetic nephropathy by means of dialysis are evaluated. Hemodialysis (HD) was applied to 24 patients, continuous ambulatory peritoneal dialysis (OCPD) was employed in 33 patients and intermittent peritoneal dialysis (IPD) in nine patients. Cumulated experience with each technique was 529, 644, and 107 months, respectively. Ten patients were treated with a combination of two or three techniques. Hospitalization rate in patients receiving CAPD was 32 days/year, peritonitis was the most frequent condition leading to admittance (54.8%), followed by cardiovascular alterations (14.4%) and gastrointestinal complications (10.5%). On hemodialyzed patients, hospitalization rate was 24.7 days/year and complications derived from vascular access were the most frequent admittance cause (34%), followed by cardiovascular complications (20.4%) and hypertension (11.3%). Peritonitis (45%), vascular complications (15%) and metabolic impairment (15%) were the most frequent causes of admittance in IPD patients; hospitalization rate was 88 days/year. Actuarial survival in patients on CAPD was 92% during first year, 79% during second, and 64% during third and fourth years. On hemodialyzed patients, 90% of patients survived during first year and 80%, 48%, and 36% during second, third, and fourth years, respectively. On IPD, survival during first year was 63% and 12% at 18 months. By combinating two or the three methods, survival was 100% at 12 months and 88% at 4 years. Although CAPD as isolated technique may offer to diabetic patients a longer survival and HD a lower hospitalization rate, combined treatment (HD-CAPD-IPD) may provide a survival matchable to that achieved in renal transplantation.

Adult↗
PubMed1989

Analysis of factors in the prognosis of diabetics on continuous ambulatory peritoneal dialysis (CAPD): long-term experience.

After five years of treating diabetics by continuous ambulatory peritoneal dialysis (CAPD), we analyzed the factors involved in prognosis. Forty-one patients were included in the study, with a cumulative experience of 784 months. Good control of blood glucose was obtained with intraperitoneal (i.p.) insulin and the blood pressure was controlled in 87% of patients without medication, which probably favored the stabilization of visual acuity in 60% of 15 patients evaluated after two years. The follow-up of patients was longer in those who began CAPD with a higher residual creatinine clearance. In spite of large number of patients who were blind or had very poor vision, 83% of all patients were self-sufficient and well-trained for CAPD, and 39% were able to work full time. The incidence of peritonitis declined to 1 episode per 17.5 patient months associated with the introduction of new preventive measures. Patients over 50 years old had the highest mortality rate and myocardial infarction was the main cause of death. Patient survival at 6, 12, 24, 36, and 42 months was 100, 90, 80, 62, and 62%, respectively. Age and cardiac problems are important factors in survival. Self-sufficiency, rehabilitation, and low incidence of peritonitis are also important factors in the life quality of diabetic patients on CAPD.

Diabetic Angiopathies↗
PubMed1989

[Complications in diabetic patients on dialysis: experiences in 10 years of treatment using 3 technics].

In treated diabetic patients with terminal renal failure we have examined the complications arising from the dialysis technique used. 55 patients were followed up for 1.279 months. Out of the latter, 24 were on hemodialysis (HD) 33 on continuous ambulatory peritoneal dialysis (CAPD) and 9 on intermittent peritoneal dialysis (IPD). Intraperitoneal insulin in patients on CAPD best controlled glycemia. Antihypertensive therapy was not necessary in 86%, 66%, and 46% of the patients on CAPD, IPD and HD respectively (CAPD vs HD, p less than 0.001). Acute myocardial infarction was more common in patients on HD (33%) (p less than 0.05). 22% of the patients on IPD had limb amputation (IPD vs CAPD-HD, p less than 0.05). The type of dialysis method used does not seem to influence the course of the retinopathy. The neuropathy behaved in a similar manner in those on CAPD and on HD when followed up for two years. Vascular complications were frequent in those on HD with one thrombotic event every 9.7 months/patient and a new vascular access every 7.4 months/patient. Peritonitis was the main complication of CAPD and IPD which was found more frequent in the former and longer hospitalization in the latter. The election of the dialysis technique in diabetic patients can directly influence the glycemia levels and blood pressure reading, as well as heart complications and those due to the method used. However they seem to influence less the neuropathy, retinopathy and peripheral vasculopathy.

Adult↗