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Biomedical subjects

A Grau

Publications and source records attributed to A Grau.

At least 55 records · Page 3Linked to original sources

Effect of hypercholesterolaemia on platelet growth factors.

Evidence from several sources suggests that important interactions occur between platelets and low-density lipoproteins. This study was undertaken to find out if diet-induced hypercholesterolaemia affects the growth factor content in circulating platelets. Minipigs were fed either normal diet supplemented with 2% cholesterol (n = 12) or normal diet alone (n = 12). After 4 months, mean platelet volume was significantly lower (P < 0.05) and monocyte count was significantly higher (P < 0.05) in the cholesterol group. Serum and intraplatelet levels of platelet-derived growth factor (BB homodimer) and transforming growth factor beta 1 were statistically unchanged after diet. Hypercholesterolaemia did not affect the proliferative effect of either serum or platelet lysates on porcine vascular smooth muscle cells and Swiss-3T3 cells in culture. A significant positive correlation between Swiss-3T3 and smooth muscle cell proliferation was present in both groups. These results suggest that the atherosclerosis-promoting effect of hypercholesterolaemia cannot be explained by its direct effect on smooth muscle cell proliferation or by changes in serum or intraplatelet concentrations of growth factors.

3T3 Cells↗

[Growth factors and mitogenic activity in experimental hypercholesterolemia].

INTRODUCTION: Hypercholesterolemia is associated with increased platelet reactivity and changes in megakaryopoiesis, which might influence the synthesis of growth factors in the megakaryocyte. MATERIAL AND METHODS: 20 miniature pigs were randomly assigned to received 18 weeks of either regular pig chow feed (control group, n = 10) or a high cholesterol diet (cholesterol group, n = 10). Platelet count, mean platelet volume, platelet distribution width and bleeding time were determined in both groups. Intraplatelet and serum mitogenic activity was quantified by Swiss 3T3 and vascular smooth muscle cells proliferation assays. Insulin-like growth factor I and platelet-derived growth factor (BB isoform) levels were quantified in platelet lysates and in serum in both groups. RESULTS: Hypercholesterolemia was associated to a significant decrease in mean platelet volume and bleeding time, but it did not affect the proliferative effect of serum and platelet lysates nor its growth factor content. CONCLUSIONS: Taken together, our results suggest that although hypercholesterolemia affects platelet reactivity, its atherosclerosis-promoting effects cannot be explained by a direct effect on vascular smooth muscle cell proliferation or by changes in serum or intraplatelet growth factor content.

3T3 Cells↗

Circulating selectin- and immunoglobulin-type adhesion molecules in acute ischemic stroke.

BACKGROUND AND PURPOSE: Cellular adhesion molecules mediate adhesion between endothelial cells and leukocytes as a precondition for extravasation of leukocytes at sites of tissue injury. The pattern of release of circulating adhesion molecules has been characterized in patients with acute ischemic stroke. METHODS: Serum concentrations of soluble selectin-type adhesion molecules (solube endothelial leukocyte adhesion molecule-1 [sELAM-1], soluble lymph node homing receptor [sL-selectin]) and immunoglobulin-type adhesion molecules (soluble vascular cell adhesion molecule-1 [sVCAM-1], soluble intercellular adhesion molecule-1 [sICAM-1]) were serially determined (at hours 4, 8, and 10 and at days 1, 3, and 5) in 22 patients with acute ischemic stroke. As control subjects, age- and sex-matched individuals with (n = 40) and without (n = 22) vascular risk factors were studied. RESULTS: We observed increased concentrations of sICAM-1 and decreased levels of sL-selectin in patients with risk factors even in the absence of stroke. Patients with acute stroke had, in addition, an initial transient increase of sELAM-1 and a persistent increase of sVCAM-1. CONCLUSIONS: The results suggest a chronic alteration of expression of adhesion molecules sICAM-1 and sL-selectin in subjects with risk factors for atherosclerosis; they also indicate acute changes of levels of sELAM-1 and sVCAM-1 in response to acute ischemic stroke. Determination of soluble adhesion molecules could allow in vivo monitoring of the initial steps of leukocyte-mediated brain damage in acute ischemic stroke.

Aged↗

Neurocritical care for acute ischemic stroke.

Therapy for acute ischemic stroke includes general and specific measures. General management such as respiratory and cardiac care, fluid and electrolyte management, blood pressure control, and treatment of increased ICP is the basis of all stroke treatment. Specific treatment is directed to recanalization of the occluded vessel, control of life-threatening brain edema, and protection of neuronal tissue against the toxic effects of ischemia. Although controlled studies are still lacking, application of the proposed general interventions provides a high-quality standard in patients with acute stroke. Among specific therapies, medical thrombolysis has demonstrated instances of significant and sustained neurologic improvement. Several multicenter trials are underway to confirm these preliminary results. In addition to thrombolysis, cell-protecting drugs hold promise for the future. Presumably, a combination of thrombolytic and cell-protecting agents will be the treatment of choice in early stroke in the future.

Acute Disease↗

[Diarrhea, rectorrhagia and colonic ulceration following the ingestion of NSAIDs].

The lower digestive tract, in contrast to the gastroduodenal tract, is infrequently affected by non-steroidal antiinflammatory drugs (NSAID), and rarely referred to in medical literature. We report the case of a 40-year-old man who presented with bloody diarrhea following treatment with NSAID. The fiber gastroscopy was normal. The fiber colonoscopy showed elongated aphthous ulcers with fibrin in the sigmoid colon. Others studies were normal. After withdrawal of NSAID, the patient returned to normal, as did the fiber colonoscopy. The treatment with NSAID has been linked with ulcerative lesions in the lower digestive tract, perforation, bloody lesions, perforation of diverticuli, reactivation of quiescent colitis and stenosis. In spite of this, doubts persist about the frequency of presentation, high risk doses and its pathophysiological mechanism, which probably involves blocking the cyclooxigenase system and the formation of the leukotrienes and free oxygen radicals. Taking into consideration the above factors, more care should be taken in investigating colonic involvement in patients who present with gastrointestinal bleeding following treatment with NSAID.

Adult↗

[Colorectal cancer. Study of survival and surgical results].

The aim of this study was to assess the progress in the surgical treatment of colorectal carcinoma in a 15 years period at the Catholic University Clinical Hospital. The medical records of 397 patients were retrospectively analyzed. Two hundred eighty four patients (164 male) aged 24 to 90 years old, subjected to elective and curative interventions, were selected for the study and separated in two groups: 132 subjects operated between 1975 and 1984 (group A) and 152 operated between 1985 and 1989 (group B). Group B patients were older (66.7 vs 61.3 years old), had a higher proportion of Dukes A tumors (11 vs 18%) and a lower proportion of lesions localized in the rectum (37 vs 49%). Rectal operations had higher morbidity than colonic interventions (35 vs 17.5%). Operative mortality was 0.7% in group A and 0.6% in group B. Ninety one percent of patients had a mean follow up of 38 months. Five years actuarial survival was 52% in group A and 69% in group B and 58, 74 and 46% for tumors Dukes A, B and C respectively.

Actuarial Analysis↗

[Surgery of acute mitral valve insufficiency].

Between January 1980 and December 1990, 16 patients with acute mitral insufficiency were operated on an emergency basis at our institution. They represented 1.8% of all mitral surgical cases. All of them were in acute pulmonary edema and 7 in cardiogenic shock. The etiology was ischemic in 6, degenerative in 4, infectious in 3, degenerative and infectious in 2 and traumatic in 1. The pathologic mechanism was chordal rupture in 8 patients (5 anterior) and papillary muscle rupture in the other 8 (5 posterior). A mitral valve replacement was performed in all cases. Two patients died and 7 had morbidity in the postoperative period. One patient died 6 months after surgery of congestive heart failure. Ten patients are in NYHA functional class I at a mean follow-up of 48.1 months. Acute mitral insufficiency has different etiologies and pathologic mechanisms. In spite of the severe clinical condition of these patients, mitral valve replacement has good immediate and long-term results.

Acute Disease↗

[Crohn's disease: clinical presentation and results of surgical treatment].

Surgery has an important role in the treatment of Crohn's disease (CD). The objective of this communication is to assess the results of surgical treatment in CD, trying to identify recurrence risk factors. A retrospective review of the charts of 120 patients with CD seen between 1963 and 1990 was made. One third of these patients required surgical treatment. The series was divided in two groups. Group A comprised patients treated from 1963 to 1977. Of these, 30% had ileal localization of the disease and 20 patients were submitted to 20 surgical procedures. The major surgical indication was intestinal obstruction and resection was performed in 85% of patients. Morbidity was 20% and mortality 10%. Group B comprised patients treated from 1978 to 1990. Nineteen patients were submitted to 22 surgical procedures. The disease was localized in the ileon in 50% of these patients. Twenty one surgical procedures were resective with a 9% complication rate and no surgical mortality. Eighty percent of patients in this group has a complete follow up. In 47% the disease recurred 37 months (as a mean) after surgery. No effect of age, sex or localization of the disease on the risk of recurrence was observed. It is concluded that morbidity and mortality of surgical treatment for Crohn's disease has decreased and a prolonged control of symptoms has been achieved. No recurrence risk factors were identified in this study.

Adult↗

[An unusual cause of generalized peritonitis: intraperitoneal rupture of an infected urachal cyst. A case and review of the literature].

The authors report a case of acute peritonitis due to intraperitoneal perforation of an infected urachal cyst. A review of the literature found only 15 similar cases. The presence of a lower midline mass, an umbilical discharge together with ultrasound examination should suggest the possibility of urachal pathology, especially and urachal cyst, with subsequent surgical treatment.

Bacterial Infections↗

[Tracheobronchial amyloidosis: a report of a new case].

Tracheobronchial amyloidosis is the most frequent manifestation of pulmonary amyloidosis. We present the case of a patient who initially presented pneumonia with atelectasis in the upper right lobe (URL) and in whom the presence of nodular bodies in all the bronchial tree was detected with bronchoscopy, with almost complete obstruction of the URL bronchus, identified as amyloid AL. Therapy with laser photoresection was effective, with almost complete resolution of the obstruction.

Aged↗

[Biphasic viral hepatitis "A" associated with autoimmune phenomena].

Acute hepatitis A virus infection (HAV) is a benign, self limited disease with infrequent extrahepatic features unlike the hepatitis B or the nonA-nonB virus infection. We describe the case of a 37 year old white woman with HAV who had a relapse with a second elevation of the alanine aminotransferase level together with joint pain, skin lesions, angioneurotic edema, and autoantibodies (ANA, anti smooth muscle, antiparietal gastric cells). The liver biopsy showed piecemeal and early bridging necrosis. She had a rapid reversal of her clinical, biochemical and histological abnormalities. As far as we known, this is the first reported case of autoantibodies or angioneurotic edema associated with HAV. We comment on the pathogenesis of this rare association.

Adult↗

[Creatine phosphokinase in leptospirosis].

Leptospirosis is a widely-distributed infectious disease, that usually presents with fever, headache and myalgia. Organ involvement could have very different severity degree. We evaluate 21 patients with leptospirosis looking for prognostic and diagnostic value of myalgia and/or elevated creatine-phosphokinase serum levels. Myalgia was recorded in nearly all patients (91%). Creatine-phosphokinase levels above normal limits were seen in 37% of cases, either in severe forms of leptospirosis with organ involvement or in mild forms of disease. We conclude that creatine-phosphokinase elevated levels could be of early diagnosis interest but they are not solely seen in the more severe forms of the disease.

Adolescent↗