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Biomedical subjects

R Velicia

Publications and source records attributed to R Velicia.

11 recordsLinked to original sources

Liver transplantation: experience with our first 100 cases.

OBJECTIVES: Our goal was to evaluate the results of the first 100 liver transplants performed in our institution. METHODS: We retrospectively analyzed the first 100 liver transplants undertaken in adults from November 2001 to August 2005. RESULTS: The mean age of the recipients was 50 years (20 to 69) and 73% were men. The mean waiting time was 35 days. The mean age of the donors was 60 years (15 to 87), and 60% were men. One-year patient and graft survival rates were 93% and 90%, respectively. Three-year patient and graft survival rates were 85% and 82%, respectively. The need for retransplantation was 3%. Surgical complications included hepatic artery stenoses, 2%; hepatic artery thromboses, 2%; biliary leaks, 6%; and biliary stenoses, 14%. CONCLUSIONS: These results are no different from the overall results for liver transplantation in Spain during the same period.

Adult↗

Long-term effects of ursodeoxycholic acid in primary biliary cirrhosis: results of a double-blind controlled multicentric trial. UDCA-Cooperative Group from the Spanish Association for the Study of the Liver.

BACKGROUND/AIM: The aim of this study was to assess the efficacy of ursodeoxycholic acid (UDCA) for primary biliary cirrhosis in a randomized, double-blind placebo-controlled trial. METHODS: Consecutive patients (n=192) were randomized to receive 14-16 mg UDCA/kg/day or placebo. Patients underwent a complete history, physical examination, liver chemistries, immunological determinations and liver biopsy at entry and at the end of the trial, which lasted for at least 2 years. Patients were seen every 3 months and the median follow-up was 3.4 years (range 0.3 to 6.1 years). RESULTS: Patients receiving UDCA (99) or placebo (93) were comparable with regard to age, sex, biochemical parameters and liver histology. UDCA treatment was associated with decreases in alkaline phosphatase, gammaglutamyl transferase, alanine aminotransferase, and cholesterol levels, effects which were conspicuous after 3 months of treatment and remained similar during the follow-up. During the study 31 patients (10 receiving UDCA and 21 placebo) discontinued the trial because of noncompliance (n=11), voluntary withdrawal (n=19) or adverse effects (n=1). Treatment failure (death or liver transplantation) was observed in 17 patients receiving UDCA and in 11 patients receiving placebo. Times to death or liver transplantation and to clinical complications were not significantly different in patients receiving UDCA or placebo. Histological analysis indicates that UDCA improved portal inflammation and prevented histological stage progression. By contrast, histological stage as well as ductular proliferation and ductopenia progressed in patients receiving placebo. CONCLUSIONS: Although UDCA treatment did not significantly affect time to death or liver transplantation and to clinical complications, the effects on both cholestasis and liver histology suggest that UDCA is safe and may be useful for preventing the progression of primary biliary cirrhosis.

Cholagogues and Choleretics↗

Carcinoma of the extrahepatic biliary tree: analysis of 15 cases.

AIM: to analyze the epidemiology, prognosis and treatment of those diagnosed as having cholangiocarcinoma of the extrahepatic biliary tree. METHODS: a prospective study including all cases diagnosed over a period of 26 months. Fifteen patients with primary bile duct carcinoma were included. RESULTS: the incidence rate was 3.23 cases/10(4). The tumor locations were: 40% proximal bile duct, 33% distal bile duct, and 27% mid-duct. The treatments used were: curative resection in 1 case (7%); palliative surgery in 3 cases (20%); internal drainage through a prosthetic biliary stent by endoscopic retrograde cholangiopancreatography in 6 cases (40%) and by percutaneous transhepatic cholangiography in 2 cases (13%); external bile drainage in case (7%), and in the remaining 2 patients (13%) no treatment was possible. The 1-month, 6-month and 10-month survival rates were 67%, 40% and 33% respectively. Factors associated with a worse survival in this study were age over 70 years and female sex. The worst prognostic location was the mid-duct compared to the distal and proximal thirds. CONCLUSIONS: the incidence of the primary bile duct carcinoma is high in our population. The commonest location is the proximal bile duct. Curative surgical resection is possible in only a few cases, and thus the overall prognosis is very bad.

Aged↗

[Primary intestinal T lymphoma].

Primary gastrointestinal lymphoma comprises a group of distinctive clinicopathological entities. They may be of B or T-cell type. Intestinal T-cell lymphomas are much less common and include the entity: lymphomas T enteropathy-associated T-cell lymphoma, the most common, and T-cell lymphoma without features of enteropathy. The morphologic and immunologic findings suggest that derived from mucosal T lymphocytes population. Clinically, the patients were usually males with constitutional symptoms and acute perforation and/or obstruction of the small bowel. Their prognosis are very poor and tumor are very aggressive.

Female↗

Hepatic disease in the Spanish toxic oil syndrome. A thirty months follow-up study.

Clinical and biological evidence of liver disease was found in 99 out of 242 (40%) patients hospitalized with acute manifestations of the Spanish toxic oil syndrome. No patient was alcoholic. According to the severity of liver involvement, patients were classified in 3 groups and followed up for at least 30 months. Group I included 65 patients with a transient increase of serum aminotransferase activity as the only evidence of liver disease. This abnormality disappeared within 2 months in all these patients. Group II included 18 patients with raised aminotransferases and alkaline phosphatase. At the end of follow-up, liver tests remained slightly abnormal in 4 patients of this group (22%) and a liver biopsy revealed minor changes in 3 of them. Group III included 16 patients with raised aminotransferases, alkaline phosphatase and bilirubin. Thirty months after the acute episode, liver function tests remained abnormal in 8 patients (50%); a liver biopsy, performed in 5 cases, showed changes suggesting chronic biliary disease in 2, and fibrosteatosis, chronic hepatitis and minimal changes in each of the remaining 3. Pulmonary, cutaneous, vascular, neuromuscular and other extra-hepatic disturbances were noted in a large number of patients but no relationship was observed between the degree of hepatic disfunction and the presence and severity of systemic manifestations of the toxic oil syndrome.

Adult↗