PubMed Health⌕ Search

Biomedical subjects

R Pina

Publications and source records attributed to R Pina.

At least 19 recordsLinked to original sources
PubMed2005

Clinical quiz.

Explore the source record for details and available documents.

Diagnosis, Differential↗
PubMed1999

Response to treatment with interferon-alfa in patients with chronic hepatitis C and high titers of -M2, -M4 and -M8 antimitochondrial antibodies.

UNLABELLED: The prevalence of antimitochondrial antibodies (AMA) in chronic hepatitis C is 2%; titers of AMA are usually low (< 1:40). The prevalence decreases to 0.5% when the results are verified by determination of the M2 subtype (anti-M2, ELISA). In patients in whom both hepatitis C virus (HCV) and AMA are present, the therapeutic decision to give interferon-alfa is complicated, because AMA may be 'real', and if it reflects primary biliary cirrhosis, cholestasis can be triggered or exacerbated. This does not occur when AMA positivity results from induction by hepatotropic C virus; however, this is rarely the case when AMA titers are high (> 1:160). OBJECTIVE: to undertake a preliminary analysis of the submitochondrial profile of AMA in three patients with chronic hepatitis C and positive AMA titers (> 1:160). METHODS: we determined antibodies to submitochondrial particles (subtypes) -M2, -M4 and -M8 by ELISA, complement binding (CB) and western immunoblotting with Immunoblot-M2 or WIB-M2 (immunoreactive bands). RESULTS: two patients were positive for mitochondrial subtypes by ELISA (IgG/IgM subclass) and CB (ELISA M2 470/365 in patient 1 and 600/1370 in patient 2; M4 490/1200 in patient 2. CB M2 1:128, M4 1:64, M8 1:64 in patient 1, M2 1:128 in patient 2). Immunoreactive epitopes (bands) were detected with WIB-M2 for 70, 56, 51, 45 and 36-kDa molecules. Interferon-alfa treatment was unsuccessful, with biochemical exacerbation of cholestasis. In contrast, the patient with no submitochondrial particles according to ELISA, CB and WIB-M2 results responded favorable to this drug. CONCLUSION: these preliminary results suggest that analyses to detect antibodies to submitochondrial particles (-M2, -M4 and -M8 subtypes) and -M2-immunoreactive epitopes in patients with chronic hepatitis C and AMA titers > 1:160 facilitates the diagnosis of primary biliary cirrhosis, and establishes a contraindication for treatment with interferon-alfa despite the presence of HCV infection.

Adult↗
PubMed1995

[Sigmoid stenosis as a complication of severe acute pancreatitis].

We report a case of severe acute pancreatitis, of biliary etiology, complicated with a pancreatic pseudocyst and colonic stenosis localized in the sigmoid, that we interpret as secondary to the lesion produced by pancreatic enzymes spread. The treatment was surgical. Possible colonic complications in the context of an acute pancreatitis and their possible etiopathogenic mechanisms are commented. The incidence of these complications is rare and much more so the stenosis localized in the sigmoid colon.

Acute Disease↗
PubMed1994

[Refractory heart failure in a 26-year-old woman with idiopathic hemochromatosis].

Idiopathic hemochromatosis, the most frequent inherited disease in Caucasians, is frequently undiagnosed. In this disorder, characterized by a continued inappropriated absorption of dietary iron, the clinical manifestations result from damage to those organ systems in which iron has been pathologically deposited, namely, the heart and the liver. Typically, hemochromatosis becomes clinically manifest in later life and in men more frequently than in women. This has been attributed to the extra loss of iron in women through menstruation and pregnancies. Removal of the excess iron by phlebotomy will prevent all of the complications of hemochromatosis of when begun early. In this paper, we report a case of a young woman with a eight years evolution of amenorrhea, cardiac failure, diabetes mellitus and increased pigmentation of the skin, associated with biochemical markers of iron overload. It is emphasized that hemochromatosis most be excluded in all patients with a unexplained cardiac failure.

Adult↗
PubMed1983

Manometric evaluation of sphincter of Oddi after endoscopic sphincterotomy, and in patients with previous surgical sphincterotomy.

Pressures in the sphincter of Oddi and common bile duct were determined in eight patients with previous surgical sphincterotomy, and in 14 patients before and after endoscopic sphincterotomy. Motor activity in the sphincter of Oddi was seen during manometric examination in 6 out of 8 patients of the surgical group. These six patients had common bile duct stones after cholecystectomy. Endoscopic sphincterotomy equalized the choledochoduodenal gradient and reduced the sphincter pressure in all the patients except three. In two of them further extension of the length of the sphincterotomy permitted removal of the stones and substantial reduction of the motor activity of the sphincter of Oddi.

Adult↗
PubMed1982

Esophageal transection and paraesophagogastric devascularization performed as an emergency measure for uncontrolled variceal bleeding.

Thirty patients with portal hypertension underwent as an emergency measure esophageal transection for uncontrolled variceal bleeding. Murphy's anastomotic button and Prioton's clip were used for the transection in 16 patients and the Androsov autosuture stapler gun in the remaining 14 patients. According to the classification of Child, four patients were listed as class A; five, class B, and 21, class C. The survivors have been observed from one to six years. Successful control of the esophageal hemorrhage was achieved in all patients. Immediate operative deaths, within one month, occurred in 17 patients. Five patients had a recurrence of varices. Bleeding recurred in three patients. The over-all survival incidence has been 11 of 30 patients. All survivors are free of hepatic encephalopathy. Transabdominal esophageal mucosal transection with devascularization appears to be satisfactory, but according to our experience, an early recurrence of varices could be expected if the Androsov autosuture stapler gun had been used for the transection.

Adult↗
PubMedDate not supplied

Morphometric study of the esophageal mucosa in cirrhotic patients with variceal bleeding.

A morphometric study of the distal esophageal mucosa (within 5 cm above the gastroesophageal junction) has been carried out in a group of 11 cirrhotic patients undergoing esophageal transection with SPTU gun for variceal bleeding. The relative thickness of the papillae (62.2 +/- 3.9%) and basal zone (11.8 +/- 1.9%) were within normal limits. Polymorphonuclear infiltrates were not found either in the lamina propria or in the epithelium. The absence of histopathologic changes in the esophageal mucosa from patients with liver cirrhosis and bleeding esophageal varices confirms the hypothesis that gastroesophageal reflux does not play a pathogenic role in the development of variceal bleeding.

Adult↗
PubMedDate not supplied

Aggressive natural-killer cell lymphoma presenting with skin lesions, breast nodule, suprarenal masses and life-threatening pericardial and pleural effusions.

We report the clinical and laboratory findings of a patient with an aggressive Epstein-Barr virus positive CD2+/CD56+ natural killer-cell lymphoma with a high mitotic activity and complex chromosomal abnormalities presenting with life-threatening pericardial and pleural effusions, disseminated skin lesions, breast nodule and large suprarenal masses. The clinical course was characterized by resistance to chemotherapy and relapsing pericardial and pleural effusions with respiratory and haemodynamic failure. Death occurred 4 months after the first manifestations of the disease as a consequence of cardiac tamponade.

Adult↗