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Biomedical subjects

R García

Publications and source records attributed to R García.

At least 181 records · Page 10Linked to original sources
PubMed1991

[Usefulness of ketoconazole combined with cyclosporin in renal transplantation].

To reduce the cost of treatment in renal transplant patients, ketoconazole, an inhibitor of the cytochrome P-450 enzyme system, was added to their triple immunosuppressive treatment (prednisone, azathioprine and cyclosporine). Thirty seven patients were included; they received 100-200 mg/day of ketoconazole and the amount of cyclosporine given was adjusted to keep its whole blood concentration within a therapeutic range. The dose of cyclosporine was decreased 70.4% by the first month of combined treatment and 76% by the ninth month. The benefit obtained with this reduction allowed the use of cyclosporine to be extended to all the patients and to administer it permanently. In 3 patients the increase in the serum hepatic enzymes made us stop ketoconazole. In order to detect hepatotoxicity early, periodic monitoring of liver function tests is mandatory.

Adolescent↗
PubMed1991

Removal of trace metals by continuous ambulatory peritoneal dialysis after desferrioxamine B chelation therapy.

We studied the removal of aluminum (Al), iron (Fe), copper (Cu), lead (Pb) and zinc (Zn) with continuous ambulatory peritoneal dialysis, before and after desferrioxamine B (DFO) administration (2 g intravenously) in two patients with chronic renal failure and Al-related osteopathy. Both patients had 4 peritoneal dialysis exchanges (2 liters each) per day. Blood concentrations of Al increased 413% (patient A) and 190% (patient B) after DFO. Patient B had a 15% increase in Fe; other metals remained unchanged. Dialysate efflux Al concentrations had peak post-DFO increments of 761% and 840% in patients 1 and 2, respectively. Peak post-DFO increments in Fe dialysate concentration were 342% and 89.5% in the respective patients. Dialysate/plasma (D/P) concentration ratios of Al increased from pre-DFO levels (mean +/- SEM) of 0.370 +/- 0.048 to 0.523 +/- 0.061 after DFO; similarly, Fe D/P ratios increased from 0.259 +/- 0.053 to 0.446 +/- 0.075 with DFO therapy. These results indicate an increase in the ultrafiltrable proportion of Al and Fe in plasma after DFO administration. During 3 days after DFO, patient 1 had a total removal of Al and Fe of 2.9 mg and 4.9 mg, respectively. Metal removal in patient 2 was 7.6 mg of Al and 2.7 mg of Fe. Peritoneal extraction of other trace metals was minor.

Adult↗
PubMed1991

[Gammagraphy with sucralfate labelled with technetium in esophagitis].

In previous studies it has been reported that, after being labeled with technetium, sucralfate, an useful drug in peptic diseases, can be used to detect peptic lesions of the digestive tract. In this work we report our experience with this technique in the diagnosis of esophagitis. 25 studies (11 controls and 14 patients) were undertaken. Sucralfate scintigraphy was normal in the 11 control studies, and abnormal in 10 out of 14 patients. Scintigraphy was abnormal in peptic as well as caustic lesions.

Adult↗
PubMed1990

[A second drug in nonatopic asthma insufficiently controlled with beta 2-adrenergic stimulants: budesonide versus theophylline].

We assessed whether theophylline or budesonide (an inhaled corticosteroid) is the most adequate drug to be added to the treatment of patients insufficiently controlled with beta agonists (procaterol). Two comparable groups of nonatopic asthmatic adults (n = 24), aged between 16 and 66 years (42 +/- 17), were investigated in a crossed, randomized study. After 4 weeks with procaterol + 800 micrograms of budesonide, the forced expiratory flow improved (p less than 0.01), the degree of bronchial hyperreactivity to histamine was reduced (p less than 0.001), the daily recorded symptomatology almost disappeared in all and the number of procaterol inhalations was reduced (p less than 0.05). The combination of theophylline + procaterol during 4 weeks did not improve these parameters from their baseline values. It was concluded that inhaled steroids are the drugs of choice in patients with asthma which is not controlled only with beta agonists.

Adolescent↗
PubMed1990

Effects of fatty ethers and stearic acid on the gastrointestinal absorption of insulin.

Insulin degradation and inactivation occurs when the protein is given to an animal through oral route. The following compounds were assessed to determine their potential effect in increasing insulin absorption: polyoxyethylene (20) oleyl ether (Brij 99), polyoxyethylene lauryl ether and polyoxyethylene (20) cetyl ether (Brij 58). In this study the above compounds, along with stearic acid, were used to prepare granules with or without addition of insulin and were given orally to rabbits. Both glucose and insulin levels in blood were measured at different time intervals, the former with a glucometer and the latter using radioimmunoassay (RIA). To determine if there was a relationship between the glucose and the insulin levels in blood, a highly sensitive radioimmunoassay method was used to detect any small changes in the level of insulin in blood. A significant decrease in glucose blood levels (P less than 0.05) was obtained after oral administration of each of granules containing insulin. The greatest reduction was observed after half an hour of the oral administration of the granules. A similar response was obtained with the hypodermal injection of 1/5 of the oral insulin dose. Granules prepared with Brij 58 and containing insulin was the only formula that showed increase of insulin level in the blood. This was equivalent to 1/10 of the change produced after hypodermal injection of the hormone. In these experiments the changes in blood insulin levels were not directly proportional to the corresponding changes in blood glucose.

Animals↗
PubMed1990

[Achlorhydria, blood gastrin and normal gastric mucosa in high-altitude subjects].

According to current concepts, it is not feasible to associate achlorhydria with normal gastric mucosa. We have found in a group of high altitude dwellers, that it is possible to associate achlorhydria with normal gastric mucosa verified by endoscopic and histological studies. In this case, basal achlorhydria is associated with resistance to histamine stimulation and with high values of gastrinemia. The possibility of reduced parietal cell mass or the absence of gastrin and histamine receptors and of G-cell hyperfunction or hyperplasia, is discussed.

Achlorhydria↗
PubMed1990

Morphological studies of cytotoxic lesions in reversible endotoxic shock.

Reversible endotoxic shock was induced in adult rats by intravenous injection of E. coli 0111:B4 lipopolysaccharide (LPS) and the progression of metabolic and morphological alterations was evaluated. Serum samples and biopsies from adrenal gland, liver and lung were studied at different times after LPS injection. Histological changes in these tissues were observed after endotoxin administration, coinciding with both the acute-phase and the recovery-phase of shock (24-72h after LPS injection). Signs of tissue regeneration can be correlated with the regression of some serum parameters to their normal values. All these results indicate that in this experimental model of endotoxic shock, a reversible status was established, which will allow further studies of the endotoxic pathophysiological mechanisms in vivo, avoiding the complexity of the non-reversible process.

Adrenal Glands↗
PubMed1989

[Diagnostic usefulness of neurospecific enolase determination in pleural fluid].

To investigate the diagnostic usefulness of the measurement of neurospecific enolase (NSE) in pleural fluid 116 consecutive patients with pleural effusion were prospectively evaluated. In 95 of them, carcinoembryonic antigen (CEA) was also measured for comparative purposes. The habit of smoking did not apparently influence the NSE levels. In the 43 malignant effusions the mean value of NSE (25.0 +/- 27.4) was significantly higher (p less than 0.001) than in benign effusions (8.7 +/- 7.1). The values above 12 ng/ml had a sensitivity of 51% for malignancy, with a specificity of only 74%. The specific sensitivity of NSE was lower than that of CEA; neither individually nor as a whole these markers modified the diagnostic yield of cytology (67%). The mean value of NSE in tuberculous pleural effusions (14.4 +/- 8.3), different from that found in malignancies (p less than 0.05), was significantly higher (p less than 0.001) than that found in other benign diseases (6.2 +/- 4.7). The results of this study demonstrate the nonspecific character of an increased level of NSE, and the low diagnostic yield of this enzyme as a pleural tumour marker.

Adolescent↗
PubMed1989

[Acute gastroenteritis due to Vibrio parahaemolyticus in Spain. Presentation of 8 cases].

Eight cases of acute gastroenteritis caused by Vibrio parahaemolyticus in humans are described; to our knowledge, they are the first such reported cases in Spain. All cases appeared between August 20th and October 15th, with a frequency of 8.3% regarding the overall adult patients with acute gastroenteritis, and 11.5% regarding the overall patients with positive stool culture for any enteropathogenic organism. The eight strains were Kanagawa positive and in three patients other enteropathogenic organisms were isolated in addition to Vibrio parahaemolyticus, i.e. Aeromonas hydrophila in two and Salmonella serovariety enteritidis in another. In all cases fish or shellfish had been ingested outside the patients' homes; except for one patient, who ate living clams in the seaside of Galicia, all patients ingested them at seaside restaurants from the Barcelona province. The clinical features of acute gastroenteritis were definite in all patients, but no patients had significant electrolyte losses or required hospital admission. Recovery was spontaneous and no antimicrobial agents were required. All strains were sensitive to tetracyclines, aminoglycosides, cefotaxime, ceftazidime and nearly always to co-trimoxazole.

Acute Disease↗
PubMed1989

[Infected cyst of the seminal vesicle associated with malformation of the upper urinary tract and contralateral vesiculitis. Embryonal and clinical aspects].

Congenital cyst of the seminal vesicle is a rare anomaly related with developmental anomaly of the mesonephric duct that is frequently associated with unilateral malformation of the upper urinary tract. New imaging techniques (ultrasound, CT, MRI) have allowed us to rediscover and study seminal vesicle disorders and its adjacent area. These techniques have afforded a better definition of cyst characteristics, its contents and anatomic relations, thus permitting more effective surgical treatment.

Adult↗
PubMed1989

[Glucose overload test. Screening of gestational diabetes in population of pregnant women with risk factors for diabetes. Clinical experience].

UNLABELLED: Clinical utility of the Overload Test with 50 g. of Oral Glucose (PSG) is evaluated, in 513 pregnancies with risk factors for diabetes. Of the 933 PSG which were made, 13.7% were positive (limit value: plasma glucose of much less than 150 mg/dl at 1 hour); the test were made after 20 weeks of gestation in 82.8% of the cases. Of the 128 positive PSG, 73 positive Oral Glucose Tolerance Test were obtained (O'Sullivan criteria). The prevalence of gestational diabetes found in this group was 15.2%. There was no difference on the most frequent risk factors (family history, obesity and macrosomia) between the general population in the study and the group of Gestational diabetes. CONCLUSION: PSG, because of its easy application, low cost and excellent tolerance is a test which should be included among the prenatal routine test as screening for gestational diabetes in our media.

Adult↗
PubMed1989

Intrarenal manometry in the diagnosis of acute rejection superimposed on acute tubular necrosis in renal transplantation.

We used fine-needle intrarenal manometry as a guide for detection of acute rejection superimposed on protracted oliguric acute tubular necrosis occurring in the postoperative course of human renal transplantation. We followed intrarenal pressure (IRP) in 31 patients who received 32 renal transplants, 12 from living related donors and 20 from cadaveric donors. There were 19 rejection episodes and 10 episodes of transient cyclosporin A (CyA) nephrotoxicity. Nine patients had posttransplant acute renal failure. Levels of IRP (mmHg) in acute rejection were (mean +/- SD) 48.6 +/- 11.1, significantly higher (p less than 0.001) than the levels in CyA nephrotoxicity (28.2 +/- 5.21), acute tubular necrosis (24.5 +/- 5.5) and normal functioning grafts (26.4 +/- 6.63). Antirejection treatment was associated with return to normal of IRP after 10 days. Intrarenal manometry was performed routinely ever 2-3 days in patients who had postoperative acute renal failure. Increments in IRP were detected on the 7-10th postoperative day in 7 patients who had 10-25 days of post-transplant oliguria. Renal biopsy findings were compatible with acute rejection, and the patients responded to intravenous bolus of steroids. We suggest that fine-needle intrarenal manometry is a reliable test for the detection of acute rejection in circumstances when traditional parameters of altered renal function cannot be evaluated.

Acute Kidney Injury↗
PubMed1989

[Hepatic markers (Ac-HVA-IgM and AcHBc-IgM) in cases of infectious hepatitis in Dominican children].

The presence of IgM antibodies for the HVA and HBc antigens in 90 children of 15 or less years with acute hepatitis were investigated, finding that 62% (58) were positive for HVA, 8.9% (8) for HBc and 27.8% (25) did not show antibodies for HVA or HBc (non-A non-B hepatitis); comments are made on some clinical and epidemiological findings such as a higher frequency of blood transfusions in HNANB, more males in HB and HNANB, and more hepatomegaly and liver sensitivity in HNANB.

Adolescent↗
PubMed1989

Partial trisomy 13q22----qter. A new case.

A newborn male patient with a partial trisomy 13q22----qter, derived from a maternal translocation (13;15)(q22;p11) is reported. This non-frequent chromosomal anomaly leads to a characteristic phenotype easily recognizable from other craniosynostosis syndromes, in which the cranial malformation is often associated with auricular and limb defects. This phenotype includes: cranial malformation, characteristic facies, mental and developmental retardation, urologic and genital anomalies, polydactily, abnormal muscular tonicity and convulsive status. Our patient, a "pure" partial trisomy, without other associated chromosomal anomaly, is compared with the published cases.

Chromosomes, Human, Pair 13↗