Biomedical subjects

P Parrilla-Paricio

Publications and source records attributed to P Parrilla-Paricio.

9 recordsLinked to original sources

PubMed2005

FTY720 inhibits TH1-mediated allogeneic humoral immune response.

Phosphorylated FTY720 is an analog of Sphingosine 1 Phosphate (S1P) with immunosuppressive activity that negatively regulates the expression of S1P-Receptor 1. It also inhibits the migration of CD4 and CD8 single-positive T cells from the thymus to the periphery, sequesters peripheral blood lymphocytes in lymph nodes and Peyer's patches, and delays the exit of effector T cells toward the graft. The aim of our work was to study the effect of FTY720 on the kinetics of skin allograft rejection in a fully mismatched model; euthymic (Euthy) versus thymectomized (ATX) C57BL/6 mice (haplotype H-2(b)) recipients of BALB/c mice (haplotype H-2(d)) donor cells. The animals were injected daily with FTY720 (1 mg/kg) intraperitoneally for 2 weeks. To monitor the humoral immune response, serum samples collected at day 0 (pre-immune) and at day 23 after skin graft rejection were examined using BALB/c thymocytes as antigens in flow cytometry. To confirm the effect of FTY720 on peripheral lymphocytes, peripheral blood was analyzed by flow cytometry. Euthy and ATX FTY720-treated mice showed prolongation of skin allograft survival when compared with nontreated Euthy and ATX controls (P < .005). Unexpectedly, FTY720-treated Euthy mice showed significantly delayed graft rejection when compared to similarly treated ATX mice (P < .005). The delayed graft rejection in FTY720-treated Euthy mice correlated with a reduced content of Th1-mediated IgG(2a) and IgG(2b) antibodies when compared with FTY720-treated ATX mice (P < .05). In conclusion, FTY720 delays the kinetics of allograft rejection in a fully mismatched model by inhibiting Th1-mediated humoral immune responses. The presence of the host thymus appears to be required for this phenomenon.

Animals↗

PubMed2005

[Acute liver failure caused by hepatitis C virus in the puerperium].

Hepatitis C virus (HCV) infection is a global problem in our health systems. The prevalence of infected patients in general population is about 2%. In the subgroup of pregnant woman the percentage of infected patients ranges from 1-3%. Several studies have described the relationship between pregnancy and chronic HCV infection, and in most cases serum transaminases levels return to normal values while HCV-RNA levels increase during the second and third trimester. The influence of maternal hormones after delivery in the natural history of HCV infection has not been sufficiently studied and consequently remains controversial. This case report shows the peculiar clinical course of a patient with chronic HCV infection in the puerperium.

Acute Disease↗

PubMed2002

Role of appendectomy in training for laparoscopic surgery.

BACKGROUND: This study aimed to evaluate a program of training in laparoscopic surgery based on clinical practice in the emergency room, in which laparoscopic appendectomy is the first technique that residents perform as surgeons. METHODS: A prospective nonrandomized study was conducted involving all the laparoscopies performed in emergencies with a diagnosis of acute abdomen, appendicular in origin, during the period between June 1991 and December 1997. RESULTS: There were no statistically significant differences between residents and assistants in terms of conversion rates (22/242 vs 15/158), mean hospital stay for each type of surgeon (5.2 days for residents and 5.1 days for assistants), and complications (12.8% for residents and 13.7% for assistants). Operating time, was significantly longer (p < 0.05) for residents (52.2 min) than for assistants (48 min). CONCLUSIONS: Apprenticeship in laparoscopic appendectomy can be accomplished with gradual clinical training and without the need for resort to animal experimentation laboratories.

Abdomen, Acute↗

PubMed1995

Multivariate analysis of histopathological features as prognostic factors in patients with papillary thyroid carcinoma.

A retrospective analysis of 121 papillary thyroid carcinomas was made to assess prognostic factors including histological variants which might be related to survival. The mean follow-up period was 10 years and clinical, surgical and histopathological data were studied. The survival curves were analysed by the Kaplan-Meier method and the multivariate analysis used Cox's regression model. Eighty-seven patients had well differentiated papillary cancers. The survival rate for papillary thyroid cancer was 86 per cent at 5 years and 72 per cent at 10 years. Factors showing prognostic significance for survival were tumour size, extrathyroid extension and histological type. Disease-free survival was influenced by sex, existence of a capsule and nodal metastases. Factors showing a favourable prognosis were: age under 45 years, size less than 4 cm, no extrathyroid extension and well differentiated histological type (P < 0.001). Histological subtype was one of the most important prognostic factors.

Adolescent↗

PubMed1995

Laparoscopic surgery in the management of traumatic hemoperitoneum in stable patients.

Unnecessary laparotomies in patients with abdominal traumatism (AT) who present hemoperitoneum with stable hemodynamics may be avoided if a diagnostic/therapeutic laparoscopy is performed. Between July 1992 and December 1994, 24 patients with AT and hemoperitoneum underwent this exploration: 5 were found to have a large retroperitoneal hematoma; 2, a tear in the intestinal mesenterium; 4, hepatic injuries; and 13, splenic lesions. Of the 24 patients, 9 needed conversion to open exploration: 8 during the laparoscopy and 1 shortly after operation. Mean hospital stay was 7 days (5-9). There was no morbidity or mortality in the series. Diagnostic/therapeutic laparoscopy is a method that is efficient and economical and can easily be undertaken by surgeons with experience in laparoscopy; it may be a valid alternative to conservative treatment or laparotomy in AT and hemoperitoneum patients who are hemodynamically stable.

Abdominal Injuries↗

PubMed1994

Quantification of duodenogastric reflux in patients with choledochoduodenostomy.

BACKGROUND: Frequently, patients present with symptoms after cholecystectomy (pain or discomfort in the upper part of the abdomen, postprandial fullness, bile vomiting, among others). Duodenogastric reflux has been associated with these symptoms in some patients. Therefore, this study was done to investigate this relationship. STUDY DESIGN: We evaluated duodenogastric reflux (DGR) in ten healthy patients, in ten patients who had asymptomatic simple cholecystectomy, in ten patients who had asymptomatic cholecystectomy with supraduodenal choledochoduodenostomy (CD), and in ten patients who had cholecystectomy plus CD followed by discomfort in the upper abdomen, postprandial fullness and bile vomiting, but no colicky pain or acute cholangitis. Duodenogastric reflux was quantified using continuous intravenous infusion of technetium-99m labeled hepatoiminodiacetic acid (99mTc-HIDA) and subsequently determining its concentration in gastric juice. RESULTS: All of the patients who underwent operation, whatever the technique used, had higher reflux rates than those in the control group (p < 0.001). Moreover, reflux rates were comparable in the patients who underwent simple cholecystectomy compared with patients in the asymptomatic cholecystectomy plus CD group. Conversely, when patients with cholecystectomy plus CD presented with discomfort in the upper part of the abdomen as well as bile vomiting, they had higher reflux rates than patients who underwent simple cholecystectomy (p < 0.001) and asymptomatic patients with associated CD (p < 0.001). CONCLUSIONS: Our results suggest that DGR must be involved in the genesis of these dyspeptic symptoms.

Abdominal Pain↗

PubMed1994

Intestinal obstruction and bezoars.

BACKGROUND: Bezoars are large conglomerates of vegetable fibers, hairs, or concretions of various substances located in the stomach or small intestine of humans and certain animals, mainly ruminants. Gastrointestinal bezoars have constituted a relatively common clinical reality ever since the introduction of truncal vagotomy associated with drainage or gastric resection in the treatment of gastroduodenal peptic ulcer. STUDY DESIGN: This study presents a series of 87 cases of intestinal bezoar treated in our department of general surgery. Analysis was made of data obtained retrospectively from clinical histories, together with a clinical and endoscopic review of the patients. RESULTS: Most of the patients had had previous operative treatment (76.3 percent), the most commonly used technique being bilateral truncal vagotomy plus pyloroplasty (75.8 percent). An excessive intake of vegetable fiber was revealed in 39.5 percent of the cases, and alterations in dentition and mastication in 24 percent. Operative treatment was used in all patients. We attempted to fragment the bezoar and milk it to the cecum. Enterotomy and bezoar extraction were reserved for cases where fragmentation was impossible, as enterotomy was associated with more complications (p < 0.05). CONCLUSIONS: Bilateral truncal vagotomy plus pyloroplasty and a excessive ingestion of vegetable fiber are the main factors predisposing to bezoar formation. Clinically, intestinal bezoars manifest themselves in most cases as complete intestinal obstruction. Simple roentgenography of the abdomen is the fundamental technique for diagnosing the occlusive syndrome. Treatment must be operative, during which the bezoar is fragmented and milked to the cecum. The stomach must be explored for associated bezoars.

Adult↗

PubMed1993

Role of Helicobacter pylori infection and duodenogastric reflux in the pathogenesis of alkaline reflux gastritis after gastric operations.

In patients undergoing gastric operations, we studied the relationship between data suggesting alkaline reflux gastritis (symptoms, endoscopic alterations and histologic lesions) and two factors that produce chronic gastritis (helicobacter pylori and duodenogastric reflux). Of 225 patients who underwent operations for gastroduodenal gastric ulcer at our General Surgery Unit between 1980 and 1982, 63 agreed to undergo endoscopy and biopsies. Of these 63 patients, 38 agreed to a test to quantify duodenogastric reflux (24 hour gastric pH monitoring associated with the determination of bile acids in gastric juice). According to the clinical questionnaire, patients were classified as symptomatic and asymptomatic. Endoscopy was considered either normal with mucosal lesions or mucosal lesions plus bile. In the histologic study, we considered normal mucosa, superficial chronic gastritis and atrophic chronic gastritis. Furthermore, the presence of atrophy, metaplasia, foveolar hyperplasia and helicobacter pylori was studied. Symptoms, endoscopic alterations and histologic lesions were not significantly related to helicobacter pylori, but were significantly related to the quantity of duodenogastric reflux. The symptomatic patients presented with a greater quantity of reflux than the asymptomatic patients (p < 0.05). The patients with mucosal lesions plus bile who had endoscopy showed a greater quantity of reflux than those with normal endoscopy (p < 0.001) and those with mucosal lesions without bile (p < 0.02 for pH values and p < 0.001 for bile acids). The patients with atrophic chronic gastritis presented with a greater quantity of reflux than those with normal mucosa and superficial chronic gastritis (p < 0.05, respectively), and the patients with atrophy and metaplasia and foveolar hyperplasia had more reflux than those without (p < 0.001, respectively). The patients who were helicobacter positive and negative presented with similar quantities of reflux.

Biopsy↗

PubMed1993

Duodenogastric reflux in patients with biliary lithiasis before and after cholecystectomy.

Duodenogastric reflux is quantified in ten patients with biliary lithiasis and a functioning gallbladder, before and six months after performing cholecystectomy. The results are compared with those of a control group (n = 10) with similar age and gender, without gastric or hepatobiliary pathologic factors. To evaluate reflux, we used six hour continuous intravenous infusion and subsequent determination in gastric juice of 99mTc-diethyliminodiacetic acid. Our results showed that patients with cholelithiasis have higher reflux rates than those in the control group (p < 0.001). When comparing patients before and after cholecystectomy, we confirmed that removal of the gallbladder produces a significant increase (p < 0.001) in reflux rates compared with preoperative values.

Adult↗