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R Pérez Alvarez

Publications and source records attributed to R Pérez Alvarez.

At least 19 recordsLinked to original sources
PubMed2002

[Progressive multifocal leukoencephalopathy in patients with AIDS: is there a change in patients treated with highly active antiretroviral therapies?].

AIMS: Progressive multifocal leukoencephalopathy (PML) develops in up to 4-8% of all AIDS patients. Before highly active antiretroviral therapies (HAART) the median survival was only 4-6 months. In this study we analyzed epidemiological parameters in AIDS-related LMP patients in search for differences in the incidence and prognosis between before and after HAART era. METHODS: Retrospective review of clinical histories of patients diagnosed of AIDS and PML at Hospital Meixoeiro in Vigo, Spain, between 01/01/94-31/05/97 (Before-HAART period) and 01/06/97-30/04/00 (After-HAART period). PML was diagnosed by clinical and neuroimaging criteria, with biopsy in 2 cases and positive JC virus hibridation in CSF in another case. RESULTS: We identified 12 patients (global prevalence of 3.8%, without differences between periods): 11 males, 10 intravenous drugs users (IDU), mean age of 38 years (31-43). In 6, LMP was the first opportunistic infection. When PML was diagnosed, 6 patients had a HIV viral load (VL) > 250.000 copies of RNA/ml (range, 254.003-3.170.000), and overall a mean CD4 lymphocytes counts of 89 x 10(6)/ml (40-134). Three patients received cytarabine + Interferon with zidovudine (2 patients) and zidovudine + lamivudine (1 patient) and other patient HAART + cidofovir, but no improvement was observed. The median survival was 10 months in before-HAART group and 17 months in after-HAART group, with a survival > 48 months in 2 patients in the last group. CONCLUSIONS: LMP is observed in severely immunosuppressed IDU men (VL > log 5 copies RNA/ml and CD4 < 150 x 106/ml). Complementary treatments were ineffective and only in patients with HAART a prolonged survival was observed.

Acquired Immunodeficiency Syndrome↗
PubMed2002

[Contribution of Galician hospitals to national and international Internal Medicine scientific meetings].

OBJECTIVES: To evaluate the scientific contributions of internal medicine services from Galicia to nationals and internationals specialty meetings and to describe theirs preferences in clinical research. MATERIAL AND METHOD: We analysed the communications from the Abstracts books of the last four Spanish Internal Medicine National Congress (1994-2000 period) in comparison with that of 1984, the last two European Congress (1999 and 2001) and the last World Congress (2000). Case reports were excluded. RESULTS: An increasing number of communicating hospitals and a sustained number of reports was observed with a minimum of 2 hospitals (1984) to a maximum of 12 (1996) with 5-6 hospitals on average. Number of communications became stable and reached 5% of the whole spanish reports. Cardiovascular and AIDS-Infectious diseases were the preferred research fields. CONCLUSIONS: An increment of scientific communications from a growing number of galician hospitals was observed. This scientific production became continuous and stabilized notoriously on cardiovascular and AIDS-infectious disease fields.

Bibliometrics↗
PubMed2001

[Seasonal changes in hospitalization and mortality resulting from chronic heart failure in Vigo].

OBJECTIVES: Circannual variation in morbi-mortality for ischemic heart disease is well-known but there are few data focusing on chronic heart failure (CHF). This report analyzes seasonal variations in CHF hospitalizations and mortality in Vigo, Northwest of Spain. METHODS: Data on hospital discharge reports with a diagnosis of CHF (3-digit ICD9 code 428) were obtained from the Clinical Documentation Service at Hospital Meixoeiro (419 beds, population: 167.000 inhabitants > 14 years old). Data were divided in three 4-months periods: winter (november-february, years: 1997-98, 98-99 and 99-00), spring (mars-june, years: 97, 98 and 99) and summer (july-october, years: 97, 98 and 99). Hospitalization rates and mortality were also studied at Cardiology, Internal Medicine and Geriatrics (attending to 81% of patients with CHF). RESULTS: A total of 1.472 CHF hospitalizations were registered (52% male, 83% > 65 years, mean inhospital stay: 13.8 days). Significatives winter increases were noted in global hospitalizations -4.9% (winter) vs. 3.2@1000 (summer) and overall medical services admissions -9.3% (winter) vs. 6.2@1000 (summer). These increases also were observed at specific medical services (Cardiology: +4.9%, Internal Medicine: +6.5%, Geriatrics: +3.2%). There was not seasonal differences in letality or attributable mortality for CHF. Death in patients with a diagnosis of CHF was 4 times more likely. (OR: 3.81; 95% CI: 3.28-4.42). CONCLUSIONS: There are a striking increase in winter hospitalizations for CHF. This diagnosis is associated with an excess of inhospital mortality. Preventive and therapeutic measures taking in account this observation are warranted to reduce the burden of this growing problem.

Aged↗
PubMed2000

[Usefulness of autoantibodies in the study of autoimmune liver diseases and prevalence of autoimmune extrahepatic manifestations].

BACKGROUND: Autoantibodies are prominent findings in the diagnosis of autoimmune liver diseases. However, their usefulness is limited due to the high reported prevalence in others nonautoimmune disorders. The purpose of this report was to assess the significance of these markers in patients with autoimmune liver diseases and to determine the prevalence of extrahepatic autoimmune phenomena. METHODS: We evaluated the samples from all the patients with altered biochemical liver parameters (ALT, AST, alkaline phosphatase or bilirubin) and a complete profile of autoimmunity [Anti-nuclear (ANA), anti-mitocondrial (AMA), anti-smooth muscle (SMA) and anti-liver/kidney microsomes (LKM1) antibodies] received in the Immunology Laboratory from 1993 to 1996. The records of the patients with at least one positive serologic marker were retrospectively reviewed. Autoimmune liver diseases (Autoimmune hepatitis (AIH), Primary biliary cirrhosis (PBC) and Overlap syndromes) were diagnosed according to composite clinical, analytical, histological or response-to-treatment parameters. RESULTS: Samples from 548 patients were analyzed. Of these 85 (15.5%) were positive for at least one antibody. Disorders and autoantibodies were: Autoimmune liver diseases: 18 (4 AIH, 11 PBC, 3 Overlap syndromes); alcohol-induced liver disease: 14 (5 ANA, 9 SMA), Chronic HCV infection: 28 (9 ANA, 17 SMA, 2 ANA + SMA), Chronic HCV + AIH: 2 (1 ANA, 1 ANA + SMA); other liver diseases: 7 (4 ANA, 1 AMA, 2 SMA); other diseases with liver involvement: 10 (8 ANA, 2 SMA); no liver disease (normal): 6 (3 ANA, 1 AMA, 2 SMA). In 75% (64/85) of the positivities processes regarded as immunological liver disease were not found. We identified in 12 out of 20 patients with autoimmune liver diseases others autoimmune extrahepatic processes; in 4 before a diagnosis of liver disease was made. CONCLUSIONS: Autoimmune serologic markers are useful in the study of liver diseases. However, due to inespecifity each individual patient deserves a careful evaluation. Autoimmune extrahepatic manifestations are often found and in some cases allow to recognize the hepatic involvement.

Autoantibodies↗
PubMed1990

[Neurologic manifestations of polycythemia vera. Analysis of 24 cases and review of the literature].

Neurological symptoms (NS) of 33 patients diagnosed as suffering from polycythemia vera (PV) are described. 24 of them (73%) had NS at some point in their evolution, the most frequent being related to blood hyperviscosity (headache 51%, dizziness 36%, paresthesias 30%, sight alterations 21%). 5 patients had ictus (15%) and there were no bleeding symptoms in the nervous system. There were no significant differences (p greater than 0.05) in age, sex; hematocrit, platelet or volume of packed red cells, between patients with NS and those without NS. A complete remission of NS was obtained reducing the hematocrit, except in ictus patients. We did not find mortality, as a result of NS.

Adult↗
PubMed1990

[Prognosis of patients with irritable intestine syndrome. A prospective study with 1 year follow-up].

An analysis was made of the prognosis over a one-year follow-up period of a consecutive series of 86 out patients with irritable bowel syndrome (SII) who were treated randomly with an antispasmodic (otilonium) or a tranquilizer (clobazam), and the existence of factors, mainly psychological, that could worsen it was determined with the Zung anxiety test and the Hamilton depression scale. We confirmed that irritable intestine syndrome is a chronic disease, with a mean course of 13 +/- 12.5 years at the time of consultation. A large proportion of patients had permanent problems (58.1%) and did not experience important changes in the intensity of symptoms throughout evolution (68.6%). Although most improved initially with the treatment instated (76.7%), the improvement was rarely complete (11.8%). A year after beginning treatment, 61.6% were the same or worse than before the index consultation. In the group of patients with a good course, the proportion of those that correctly followed medical treatment and of those who had experienced more or less lengthy asymptomatic periods before consultation was significantly larger. In the group of patients with poor evolution, the scores on the Zung anxiety test and Hamilton depression scale were significantly higher than in those who evolved favorably. Neither consultation of a specialist nor the treatment used in this study seem to have contributed to an evident improvement in the prognosis.

Adolescent↗