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R Barcena

Publications and source records attributed to R Barcena.

At least 19 recordsLinked to original sources
PubMed2001

Aspergillus antigenemia sandwich-enzyme immunoassay test as a serodiagnostic method for invasive aspergillosis in liver transplant recipients.

BACKGROUND: Invasive aspergillosis (IA) is an important cause of mortality in liver transplant patients. Clinical and microbiological diagnosis is difficult, and it is frequently achieved only after autopsy. Early diagnosis and antifungal therapy could improve the survival of these patients. METHODS: A retrospective case-control study of IA in liver transplant recipients (OLT) was performed to determine the value of the detection of galactomannan Aspergillus antigen in serum using a sandwich-ELISA test (Platelia, Sanofi Diagnostic Pasteur). Stored frozen serum specimens obtained during the posttransplantation period were used. RESULTS: Fourteen cases of IA were diagnosed in 240 OLT recipients (IA incidence: 5.8%) during 5 years with 13 deaths (mortality: 93%). Nine case patients and 33 control patients met the criteria required for being considered "valid" for antigenemia analysis. In five of the nine case patients, a serum sample was positive for Aspergillus antigenemia detection. The median value was 5.7 ng/ml (range: 1.6-6.6). Sensitivity of the test was 55.6%, specificity was 93.9%, the positive predictive value was 71.4%, and the negative predictive value was 88.6%. The likelihood ratio of a positive test was 9.2. CONCLUSIONS: Galactomannan detection in serum could be useful for an early diagnosis of IA in OLT recipients.

Adult↗
PubMed2001

Role of Helicobacter pylori infection and its eradication in patients with subclinical hepatic encephalopathy.

AIMS: Helicobacter pylori infection in cirrhotic patients has been associated with episodes of hepatic encephalopathy (HE), although conclusive data are still lacking. This prospective study has evaluated the prevalence of H. pylori infection in 37 patients with advanced cirrhosis of the liver and subclinical hepatic encephalopathy (SHE), diagnosed by changes in psychometric tests and/or electrophysiological tests, as well as the repercussion of H. pylori eradication on ammonaemia and the evolution of this disorder. RESULTS: A positive result for H. pylori infection was obtained in 22/37 (59%) patients. Initial fasting blood levels of ammonia were high in both groups. Infected and non-infected patients showed similar levels (62.05 mmol/l v. 62.5 mmol/l), which were lowered by the standard diet, although statistical significance was only reached in the infected patient group (53.05 +/- 26 mmol/l; P < 0.05). Infection was eradicated in 19 patients, but no reduction of blood levels of ammonia was observed after H. pylori eradication among infected patients (52.37 +/- 29 mmol/l). No change has been found in either group after the administration of diet or antimicrobials with regard to psychometric and/or electrophysiological tests. CONCLUSIONS: H. pylori infection does not contribute significantly to high blood levels of ammonia in patients with advanced cirrhosis and SHE. Likewise, H. pylori eradication does not induce any improvement in the psychometric and/or electrophysiological tests used to define SHE.

Adult↗
PubMed1994

Prevalence of antibodies to hepatitis C virus after blood transfusion in heart surgery.

We studied the frequency and time of appearance of antibodies to the hepatitis C virus (HCV) retrospectively in the sera of 127 patients who underwent heart surgery between 1983 and 1986. They received blood from volunteer donors hepatitis B surface antigen (HBsAg) negative with normal serum alanine-aminotransferase levels. A prospective follow-up was carried out every 15 days for at least 6 months from the moment of the transfusion. Of the ten patients who developed biochemical criteria of post-transfusional non-A non-B hepatitis, six seroconverted to anti-HCV (60%). Of the other 117, two were already positive before transfusion (1.51%), one patient showed antibodies only in the first post-transfusional serum (passive transfer), and another two patients with no evidence of post-transfusional hepatitis developed HCV antibodies on the 90th day, remaining indefinitely (afterwards seroconversion without hepatitis); both patients' earlier sera were anti-HCV negative. Four (40%) of the ten patients with post-transfusional hepatitis did not develop any serum markers to known hepatotropic agents. Although these findings do not exclude a viral infection by these viruses, they are consistent with the involvement of an unidentified non-A, non-B, non-C agent.

Blood Transfusion↗
PubMed1994

[Immunologic changes in chronic post-transfusion positive hepatitis C and non-A non-B non-C hepatitis].

OBJECTIVES: To study some aspects of the immunological abnormalities of C and non-A non-B non-C posttransfusional chronic hepatitis through the spontaneous and mitogen-stimulated "in vitro" production of immunoglobulins by peripheral blood lymphocytes. EXPERIMENTAL DESIGN: Peripheral blood lymphocytes from non-A non-B posttransfusional chronic hepatitis patients and from healthy volunteers were cultured in presence and absence of Pokeweed mitogen and the secreted immunoglobulins (IgG, IgA and IgM) were measured by ELISA in the supernatants. The results in both groups were compared. PATIENTS: 23 posttransfusional chronic hepatitis patients, 11 males and 12 females with an average age of 46.73 +/- 11.2 yrs (range: 24-69 yrs), have been studied. The histological diagnosis was chronic active hepatitis (CAH) in 13 cases, CAH with bridge necrosis in 6 patients and CAH with associated cirrhosis in 4 cases. The control group was composed by 11 healthy volunteers, 5 male and 6 female, with an average age of 38.45 +/- 12.77 yrs (range: 26-65 yrs). No one of the control group was positive for anti-HCV antibodies while in the posttransfusional chronic hepatitis patients group, 19 were positive and 4 negative. RESULTS: No significant differences in the spontaneous production of immunoglobulins between both groups has been found, however, when peripheral blood lymphocytes were stimulated with Pokeweed mitogen, a statistically significant lower production of immunoglobulins was observed in chronic hepatitis patients when compared with the control group. In non-A non-B posttransfusional chronic hepatitis patients, no relation has been found between the immunoglobulins production and histological findings or anti-HCV antibody titles. CONCLUSIONS: In the chronic phase of C and non-A non-B non-C posttransfusional chronic hepatitis, stimulated immunoglobulin production is significantly decreased for each immunoglobulin compared with the control group. These results suggest a failure in T-B lymphocyte cooperation in these infections since 82.6% of our patients were positive for HCV serological markers.

Adult↗
PubMed1994

[Prevalence of Helicobacter pylori infection in symptomatic adults].

AIM: To study the prevalence of Helicobacter pylori infection in different gastroduodenal entities in a wide group of symptomatic patients of our area. MATERIALS AND METHODS: 796 (493 females) patients referred to our Hospital for upper gastrointestinal endoscopy were studied. Mean age was 51.1 +/- 16.6 yrs. In all patients biopsies samples were taken from the gastric antrum for histological and microbiological (urease test) studies. A patient was considered Helicobacter pylori negative when its presence was not proved by microbiological and histological methods. RESULTS: 70.9% (73.8% males and 64.7% females) were Helicobacter pylori positive. The great majority of patients belong to 4. and 5. decade. Endoscopic diagnosis were: normal endoscopy 47.4%; antral gastritis 79.9%; pangastritis 68%; gastric ulcer 75.9%; duodenal ulcer 98.2%; pyloric ulcer 94.7%; endoscopic duodenitis 95.7%; gastric cancer 31.9%; operated stomachs 45.6%; and esophagitis 33.3%. CONCLUSIONS: The urease test had a high specificity (100%) and sensitivity (90%). Global results of H. pylori infection and its distribution among different gastroduodenal entities was similar to those described in other publications in our setting, although the prevalence was lower when compared with those countries with a lower socioeconomic status. H. pylori infection age-distribution suggests that this infection is acquired throughout life.

Adolescent↗
PubMed1993

[Treatment of hepatic and intra-abdominal hydatidosis with mebendazole: prospective comparison of the cyclic and the continuous regimen].

AIM: To communicate the results of two different schedules (cyclic and continuous) of mebendazole therapy for hepatic and intraabdominal hydatid disease. DESIGN: Prospective and randomized. PATIENTS: 26 cases of abdominal hydatid disease. RESULTS: No significant differences were registered between both groups. CONCLUSION: Cyclic mebendazole therapy does not improve the results of continuous treatment in abdominal hydatid disease.

Abdomen↗
PubMed1993

Frequency and chronology of occurrence of anti-HCV in non-A non-B post-transfusional hepatitis.

OBJECTIVE: Studying the frequency and timing of the appearance of the virus C antibody. PATIENTS: We studied serum samples of 57 patients whom developed post-transfusional non-A non-B hepatitis. 34 males, and mean age was 47.56 +/- 13.45 years. Initially anti-HVC was detected by ELISA, and the test was repeated on the last negative sample and the first two positive ones of each patient. RIBA-I and 2nd generation ELISA were performed on these same samples. HCV polymerase chain reaction was performed in 5 seronegative patients by the other techniques. RESULTS: Fifty patients (87.5%) seroconverted to anti-HCV; 26 (52%) within 30 days after the onset of the disease (11 during incubation period); and, 24 (48%) seroconverted after the first month of the disease. Anti-HCV negative patients had lower transaminase levels. Twenty six (52%) of the 50 patients showing seroconversion developed a chronic hepatitis, while this occurred in two (28.5%) of the seven seronegative patients (this difference was not statistically significant). Determination of HCV-RNA by polymerase chain reaction, performed (eight years after the onset of the disease) in 4 of the five seronegative patients by ELISA and RIBA techniques, was negative. Nowadays one of them is anti-HCV and HCV-PCR positive and sustain normal transaminases values. CONCLUSIONS: 87.5% of post-transfusional non-A non-B hepatitis seroconverted during the follow-up. 26 (52%) showed this within 30 days after the onset of their disease; of this group, 11 became seropositive before their ALT values rose. Nowadays in all patients (except one) initially seronegative, in which polymerase chain reaction was performed, negative serology results persist. There were no clinical and evolution differences between the groups.

Adult↗
PubMed1992

[Carney's triad: a short review apropos a case].

We communicate a case with the Carney triad (gastric leiomyosarcoma, pulmonary chondromatosis and extra-adrenal paraganglioma). It is, to our knowledge, the first case to be communicated in the Spanish scientific literature. We discuss some peculiar aspects of the debut and clinical evolution of this syndrome, together with its prognosis. We conclude that in clinical practice, the appearance in a young subject, specifically females, of multiple gastric myogenic tumors, should elicit the performance of further noninvasive procedures, needed to discard the diagnosis of the Carney triad.

Adult↗
PubMed1990

Spontaneous peritonitis caused by Enterococcus faecium.

Three cases of spontaneous peritonitis caused by Enterococcus faecium are presented. The underlying condition was alcoholic cirrhosis in each case. This enterococcal species has never before been reported as a cause of spontaneous bacterial peritonitis. Two patients responded to therapy. The development of enterococcal peritonitis and the cases documented in the literature are briefly reviewed. Taxonomic problems with pathogenic, clinical, and therapeutic implications are discussed.

Ampicillin↗
PubMed1989

[Spontaneous bacterial peritonitis: clinical, microbiological and clinical course study of 89 episodes].

We have retrospectively studied 89 episodes of spontaneous bacterial peritonitis (SBP) attended at our service with the purpose of analyzing clinical features, microbiologic data and possible etiopathogenic factors, treatment and course. The most frequent symptoms were ascites, abdominal pain and fever. Only 3.3% of episodes were asymptomatic. Twenty-four episodes (26.96%) resulted in death of the patient and only the presence of septic shock and prothrombin time lower than 35% statistically correlated with a higher mortality (100% and 53.8%, respectively, p less than 0.01) of the possible factors analyzed. The culture of ascitic fluid (AF) was positive in 52.8% of the episodes and there were no clinical or time course differences between these cases and those who presented negative culture. The isolated microorganisms were the usual ones in this condition, outstanding 37.5% of gram-positive cocci in monomicrobial SBP. Treatment was initiated within the first 12 hours from admittance in 76.4% of cases, between 12 and 72 hours in 12.3% and after 72 hours in 11.2%. Cefotaxime was given to 47.1% of episodes and 52.9% of patients received ampicillin or cefoxitin plus aminoglycoside; the mortality was lower with the first schedule (11.9% versus 40.4%, p less than 0.01).

Adult↗