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Biomedical subjects

R Pérez García

Publications and source records attributed to R Pérez García.

At least 19 recordsLinked to original sources
PubMed2004

[Guidelines for quality management of dialysis solutions].

A Best Practice Guideline about Dialysis fluid purity has been developed under the leadership of the Spanish Society of Nephrology. The Guideline has established recommendations for standards for preparing dialysate: water, concentrates and hemodialysis proportioning systems. The Guideline was based on the European pharmacopoeia, the Real Farmacopea Española, the AAMI Standards and Recommended Practices, European Best Practice Guidelines for Haemodialysis (Section IV), literature reviews, according to their level of evidence, and the opinion of the expert spanish group. Two levels of quality of water were defined: purified water and high purified water (Ultra pure) and for dialysate: standard dialysate and ultra pure dialysate. Regular use of ultra pure dialysate is necessary for hemofiltration and hemodiafiltration on-line and desirable for high-flux hemodialysis to prevent and delay the occurrence of complications: inflammation, malnutrition, anemia and amyloidosis. Water, concentrates and dialysate quality requirements are defined as maximum allowable contaminant levels: chemicals (1.1.2), microbial and endotoxins: [table: see text] Monitoring frequency, maintenance and corrective actions were specified. Methods of sampling and analysis were described in appendix (Anexos). For microbiological monitoring, TSA or R2A medium are recommended, incubated during 5 days at a temperature of 30-35 degrees C. The dialysate quality assurance process involves all dialysis staff members and requires strict protocols. The physician in charge of hemodialysis has the ultimate responsibility for dialysate quality. All suggestions and questions about this Guideline are wellcome to www.senefro.org

Disinfection↗
PubMed2002

[Efficacy of latanoprost monotherapy treatment in primary open-angle glaucoma].

PURPOSE: To determine the efficiency and safety of latanoprost in glaucoma patients previously treated with Betablockers. METHODS: Latanoprost 0.005% was applied topically once daily without washing period in 60 eyes with primary open-angle glaucoma. The baseline intraocular pressure (IOP) was compared with post-latanoprost IOP for each yee. Responders were defined as those who had at least a 15% IOP reduction on latanoprost, whereas non-responders showed under 15% IOP reduction on latanoprost. RESULTS: Baseline IOP of 23.50 S.D. 2.87 mm Hg (Mean SD) fell to 17.67 S.D. 1.62 mm Hg after 12 months of follow-up. Fifty-three eyes were responders, with an average IOP reduction of 28.28 S.D. 6.81%. Seven eyes were considered as non-responders with an average IOP reduction of 3.12% S.D. 2.98%. Five eyes (8.3%) had a demonstrable increase in iris pigmentation. CONCLUSIONS: Latanoprost, administered once daily, appears to be more active than betablockers in reducing intraocular pressure. Although further studies may be needed to confirm and evaluate the side effect of the increase in iris pigmentation (Arch Soc Esp Oftalmol 2002; 77: 269-274).

Antihypertensive Agents↗
PubMed2001

[Pre-occupying increase in diabetes as cause for terminal kidney failure. Evaluation of treatment strategies].

OBJECTIVE: To study the incidence, prevalence, treatment modalities and prognosis of diabetic patients on renal replacement therapy. MATERIAL: We studied all end-stage renal failure (ESRF) diabetic patients on renal replacement therapy in "Area Sanitaria 1" in Madrid from 1978 to 1998. RESULTS: Diabetes mellitus has become the leading cause of ESRF in our health area of Madrid, 30% of all causes of ESRF. Incidence of diabetics beginning RRT was 33.3 per million population (pmp) in 1998, while in 1993-94 diabetes was 15% and 21 pmp, respectively, table 1. The proportion of diabetics on RRT has increased from 7.4% 1986 to 12.7% 1998. The prevalence of diabetics on RRT in 1998 was 135 pmp, with an overall prevalence of 1054 pmp. At the mean time, the proportion between incident diabetics type 2/diabetics on RRT has increased from 15% in 1987-88, to 54% in 1993-94 and to 81% in 1997-98, consequently, mean age of diabetic patients at beginning RRT has increased from 47 years before 1988, 58 in 1989-90, 61 in 1993-94, 62 in 1995-96 and 63 in 1997-98 (Table I). We studied 182 diabetics admitted for renal replacement therapy, 106 males and 76 females, 105 were diabetics type 1 and 77 type 2. Their mean age at RRT beginning was 57.12 years (SD). Hemodialysis (HD) was the first modality of treatment for 128 (70%) diabetics and CAPD for 54. Seventy out of 128 patients on HD were dialyzed in the Hospital Unit, 40% on AFB (acetate free biofiltration) and 58 in two Satellite Units, that means a higher proportion of diabetics on CAPD and on HD in Hospital Unit. Diabetics allocated to CAPD were 5 years, as mean, younger than patients allocated to HD (p < 0.01) and the proportion of diabetes type 1 was higher in CAPD (72%) than in HD (51%), p 0.05. During the mean follow-up period (51.45 months) 79 patients changed their treatment modality and 45 of them received a kidney allogral. Relative risk of drop-out was higher in CAPD technique when compared to HD. Clinical complications were frequently observed: ocular (77%), cardiovascular (Myocardial infarction 1.7%), acute cerebrovascular disease (21%) and distal angiopathy (35%), 10% amputee. At December of 1998, 89 patients were dead. Cardiovascular and cerebrovascular diseases (29%) and Infections (27%) were the two most frequent causes of death. Unknown-origin deaths represent 19% of all deaths. The overall survival (Kaplan Meier) was 92%, 80%, 72%, 61% and 54% at 1, 2, 3, 4 and 5 years, respectively (57 patients completed last period). Survival was better on HD than on CAPD, but without statistical significance, although the significant difference in age and in proportion of diabetes type 2 between both groups. Data analysis estimated by Cox proportional hazards regression shows that younger age and ki,r transplantation had a positive independent effect on survival, whik clinical distal angiopathy had important negative effect on survival. CONCLUSIONS: Diabetes mellitus has become the leading case of ESRF in our health area of Madrid. Young age and kidney transplantation had a positive independent effect on survival, while clinical distal angiopathy had important negative effect.

Adult↗
PubMed1990

[Determination of the degree of renal functioning and cardiovascular risk factors in an aged population seen at a health center].

We report the results of a study to assess the glomerular filtration rate in the elderly population seen at the center and to investigate the prevalence of cardiovascular risk factors and use of drugs in this age group. The glomerular filtration rate could be measured in 64.6% of the elderly population. In 94 (17.6%) of the 825 evaluated individuals the clearance values were 50 ml/min or lower. Only 6 of them had previously known chronic renal failure. A high prevalence of concomitant cardiovascular risk factors was found (48.7% were hypertensive, 25.1% diabetic, 19% smokers, 24.1% had hyperlipidemia and 38.8% were obese). The rate of drug use was also high (69.6% took two or more drugs sustainedly). These findings indicate the need to evaluate the renal function in elderly people before prescribing drug therapy.

Aged↗
PubMedDate not supplied

[Surgical treatment of carcinoma of the esophagogastric junction].

The results obtained from diagnosis and treatment of six patients with cardioesophagic junction cancer, diagnosed by histopathologic study during surgery, are presented. Three patients presented with diaphragmatic hernia as well. Esophagogastroduodenal roentgenological study was interpreted as neoplasia in three patients only; it was supposed that the other three patients had a benign esophageal stricture. Endoscopy oriented the malignity diagnosis in four patients, and for benign lesion in the other two. Biopsy showed malignant lesion in three patients and it was negative in the other three. Exfoliative cytology was positive in four patients and negative in two. Esophagogastric resection was done in four patients. One of them died post-operatively. The other have survived 36, 22 and 16 months.

Adult↗
PubMedDate not supplied

[Spanish survey on anaemia management].

The European Best Practice Guidelines for the Anaemia Management (EBPG) represents the main reference for the treatment of patients with chronic renal failure (CRF). This study was developed two years after EBPG's publication in order to evaluate the impact of theses guidelines in the clinical practice. This is an epidemiological, multicentric and prospective study including patients on dialysis and erythropoietin treatment. The aetiology of CRF, prevalence and anaemia treatment, concurrent pathologies and side effects had been evaluated during follow-up. The inclusion period was june-august 2000. Patients were evaluated during six months. Two thousands six hundred and eighteen dialysis patients were recruited from different national centres (2,171 on haemodialysis and 447 on peritoneal dialysis). Fifty one percent of haemodialysis patients and forty one percent of patients on peritoneal dialysis started erythropoietin treatment with a basal haemoglobin > 9 g/dL (mean 8.9 g/dL and 9.2 g/dL, respectively). At baseline, 35% of patients had haemoglobin < 11 g/dL (mean 11.4 g/dL), but at the study end, 21.2% had haemoglobin < 11 g/dL (mean 11.8 g/dL). Seventy nine percent of patients were treated with erythropoietin using subcutaneous route: 27.5% with once a week regimen, 33.0% in two weekly doses and 39.5% in three weekly administrations. No differences in doses requirements were showed by administration route. These results seem to support that there already exists a good knowledge of the International Guidelines for the anaemia management, but there is still a gap between them and the results in the clinical setting. In general erythropoietin treatment starts late and at low haemoglobin levels. However, close monitoring of haemoglobin levels seems to improve patient's outcomes.

Anemia↗