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R Alcázar

Publications and source records attributed to R Alcázar.

At least 19 recordsLinked to original sources

Higher graft salvage rate in renal allograft rupture associated with acute tubular necrosis.

BACKGROUND: Renal allograft rupture is an early postoperative complication threatening graft and patient survival. We reviewed the etiology and prognostic factors for renal allograft rupture. MATERIAL AND METHODS: Among 657 renal transplants performed between 1990 and 2001, renal allograft rupture was diagnosed in 10 cases. Statistical analysis by Student t test, ANOVA, and chi-square was performed to assess donor and recipient characteristics. Multivariate logistic regression to predict renal allograft rupture used variables with P <.15 in the univariate analysis. RESULTS: Patients with renal allograft rupture were mainly men and young. Renal allograft rupture incidence was higher among allografts from non-heart-beating donors, kidneys with delayed graft function, or patients with a high antibody titer. Histopathological findings revealed that six renal allograft ruptures were secondary to acute rejection, three to acute tubular rejection and one to allograft infarction. Only one of six renal allograft ruptures (17.7%) secondary to rejection was resolved by surgery; two of the three patients (66.7%) with acute tubular necrosis were successfully operated and a nephrectomy was performed for the patient with allograft infarction. By multivariate logistic regression analysis, factors shown to be predictive for renal allograft rupture were: delayed graft function, age of recipient, peak panel-reactive antibody >25%, and initial immunosuppressive treatment without antithymocyte globulin. CONCLUSIONS: Higher graft salvage rates are possible in cases of graft rupture associated with acute tubular necrosis.

Adult↗

[Guidelines on hemodialysis-associated viral infections].

The viric infections influence morbi-mortality in Chronic kidney Disease patients in hemodialysis therapy and can affect to the Staff of the Units. The guides considered the most relevant virus at the present moment: C Virus, B Virus and HIV. To prevent horizontal nosocomial transmission is necessary the observance always the universal precautions in the HD units, although sometimes can appeared seroconversions and epidemic bud when exist a break of these. Is analyzed different situations with special focus in units for acute patients. The following steps under the suspicious of the epidemic bud appeared in one of the annexes together with legislation according to this case. Respect to the staff in every one of the virus is shown prevention patterns, serologic markers to perform when an accident with infected blood occur, also is considered when treatment is indicated. The guides considered too the conditions necessary for include these patients on waiting list for kidney transplantation.

Ambulatory Care Facilities↗

[Familial focal and segmentary hyalinosis].

Focal segmental glomerulosclerosis represents a finding in several renal disorders, characterized by proteinuria and sometimes by arterial hypertension and progressive decline in renal function. There are primary (idiopathic and familial) and secundary forms. In the last 20 years several familial cases has been reported, with a great genetic heterogeneity (dominant and recessive forms) and with multiple associations with particular MHC class-I and class-II gene loci, being Al, DR3 o DR7 the most frequently reported. We described three members of same family with focal segmental hyalinosis that shared the HLA haplotype A31 B61 DR13. This association has not been described previously. We highlight that genetic and acquired factors (obesity, hypertension...) could have importance in the development of progressive renal failure in these patients.

Adult↗

Acute myocardial injury caused presumably by coronary spasm after magnesium fluoro-silicate ingestion.

A patient who developed magnesium fluoro-silicate poisoning is described. This condition was manifest by the findings of acute chest pain, dysphagia, diarrhea, metabolic acidosis, hypocalcemia and hypomagnesemia and was complicated by acute myocardial injury-a phenomenon not previously described. Coronary cineangiography showed normal coronary arteries. The physiopathologic mechanisms of this electrocardiographic finding are discussed.

Coronary Circulation↗

Pentavalent antimonial-induced torsade de pointes.

Unexplained sudden deaths following use of pentavalent antimonial drugs have been described, presumably owing to ventricular arrhythmias. A patient is reported with QT interval prolongation and syncopal episodes related to torsade de pointes following treatment of visceral leishmaniasis with meglumine antimoniate. This is the first reported case of documented torsade de pointes following treatment with pentavalent antimonial drugs.

Aged↗