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Biomedical subjects

A Luis

Publications and source records attributed to A Luis.

At least 19 recordsLinked to original sources

[Autotransfusion and pregnancy].

PURPOSE: To analyse the results of a pre-deposit autologous transfusion programme in pregnant women on their third period of pregnancy. MATERIAL AND METHODS: Fifty donor/pregnant women were included in the study. They were in the third trimester of their pregnancy and had risk of requiring transfusion during or after surgery. Haemoglobin above 11 g/dL and haematocrit above 34% were required in each case. Phlebotomy was performed at one-week intervals, iron and folate being supplied. Constants such as foetal heart frequency were evaluated, the programme being interrupted in case of foetal bradycardia. Apart from weight, Apgar and Silverman scores were applied to each newborn. RESULTS: Cephalopelvic disproportion was the commonest obstetric indication, 26 cases (52%). For autologous blood transfusion, rare blood groups, 12 cases (24%), followed by intra- or post-operative bleeding risk, 10 cases (20%) and being Jehovah's Witnesses, 9 cases (18%), were the major indications. Ninety-four blood units were drawn, 34 of them being used. The remaining 60 units were used for homologous transfusion. No complications developed during phlebotomy and the neonatal determinations showed no significant anomalies. CONCLUSIONS: (1) Autologous blood transfusion with pre-deposit in the third trimester of pregnancy is a safe and effective way of collecting blood. (2) Its indication is not reduced to rare blood groups. (3) The procedure seems to be safe for both the mother and the newborn.

Adolescent↗

[Upper digestive hemorrhage in liver cirrhosis: clinical and endoscopic findings].

There are different opinions in respect to the main sources in upper gastrointestinal bleeding in hepatic cirrhosis. Some authors claim that ruptured esophageal varices are the cause of most of the hemorrhages. Recently, characteristic lesions have been showed in the gastric mucosa in portal hypertension (congestive gastropathy), and many believe that they are frequently the origin of the bleeding. We reviewed the records of 195 episodes of upper gastrointestinal bleeding in cirrhosis, with endoscopy performed within 12 hours of entry, and report here the endoscopic findings and the bleeding sites. We also investigated the relation between the etiology and functional class of the hepatic disease and the bleeding source. We observed variceal hemorrhage in 52.2% of cases; by gastroduodenal mucosal lesions in 13.8%; by gastric and duodenal ulcers in 13.8%; undetermined origin in 14.8% (due to coexistence of two or more lesions, without active bleeding). We found no differences between alcoholic and nonalcoholic cirrhotics in the bleeding sources. Furthermore, the bleeding sites were not different either in child A, B and C patients. In contrast, in major hemorrhages, esophageal varices were more frequently the origin (73.5%) than in minor ones (40.4%) (p < 0.002). The mortality was significantly higher in CHild C group (25%), than in groups B (14.3%) and A (2.3%) (p < 0.05 and p < 0.002, respectively). We recommend to carry out early endoscopy in every cirrhotic patient suffering from gastrointestinal bleeding, by skilled performers who are able to recognize the gastric red signs, before making a decision about potentially dangerous therapeutic measures, such as surgery, balloon tamponade, etc.

Adolescent↗

[Spontaneous remission of retroduodenal sac fundus syndrome (sump syndrome)].

The Sump syndrome is an infrequent complication of a choledochoenterostomy (choledochoduodenostomy or choledochojejunostomy) performed for recurrent stone disease: a sump or pit develops at the retroduodenal section of the choledochus between the enterostomy and papilla where stones, lithogenic bile and gastrointestinal contents accumulate. This may lead to abdominal pain, pancreatitis and cholestasis and/or cholangitis when sludge obstructs the enterostomy. Surgical treatment has been replaced by endoscopic papillotomy. The major interest of this experience was that regarding migration of the stones to intestine, the spontaneous resolution could be documented in two patients; in other two cases, because of contraindications in one case and for refusing therapy in another, the stones still remain at the retroduodenal choledochus. In a follow up of two to eight years there is a favorable evolution without any surgical or endoscopic treatment of the papilla.

Aged↗

[A double-blind study with misoprostol in the treatment of active duodenal ulcer].

Misoprostol (Mi, a double blind study in the treatment of active duodenal ulcer (DU). The purpose of the paper was to evaluate the effect of Mi vs. Placebo (Pl) without antacids, assessing at the same time side effects and histological alterations. Thirty five patients with active DU diagnosed by endoscopy and photography (performed on days, 0, 14 and 28) were studied. They received 4 doses/day of Mi 100 mcg, or Pl double blind. In each control, biochemical studies in blood and urine were performed. Acetaminophen, 500 mg was the only analgesic allowed. Six patients were excluded. Of the remaining 29 patients, 15 received Mi and 14 Pl. There was no difference in healing at the 14 day stage. At the 28 day stage there was complete healing of the ulcer in 66.6%, and reduction of the ulcer diameter of 89% those who received Mi. The healing rate was 28.5% and reduction of the ulcer diameter of 31% on those patients who received placebo. There were no biochemical alterations or side effects. There was no significative difference between biopsies taken from pylorus and antrum. The consumption of acetaminophen was similar to both groups. It is concluded that Mi has a healing effect similar to H2 blocking agents, accelerating the healing of active DU, without side effects and biochemical changes.

Acetaminophen↗

[Emergency endoscopy in upper digestive tract hemorrhage].

The experience in upper G.I. tract hemorrhage accumulated during the first 30 months in the Emergency Hemorrhage Unit at the Hospital Posadas is here reported over a total of 428 endoscopies, we found 518 lesions. Ninety one (21%) presented with active bleeding, and 317 (76%) were considered as the probable cause of the bleeding. In 37 cases (8.6%) the site of bleeding was detected, but the diagnosis wasn't done. The most frequent lesions were erosive gastritis (21.2%), gastric ulcer (20%), erosive duodenitis (12.6%), duodenal ulcer (12.15%) and esophageal varices (12.12%) the diagnosis was normal 14.7% of the cases. One hundred and sixty one patients were admitted to the hospital; on 143 (88.82%) patients the original diagnosis was confirmed but it was modified in 18 patients (11.18%) by surgery or repeated endoscopy. During the last 20 months of the period the accuracy diagnostic of the endoscopy increased 95%. When compared with the first 10 months (76%) this fact shows, the importance of the experience acquired by the endoscopist. Most of the patients received medical treatment with a mortality of 9.02% and 25 patients received surgical treatment with a mortality of 28%.

Adolescent↗

Randomized double-masked trial of sodium oxyferriscorbone for the treatment of gastric ulcers.

A double-blind 4-week trial of sodium oxyferriscorbone versus placebo (distilled water) was conducted in 46 outpatients with endoscopically confirmed gastric ulcer. Ulcer healing occurred in 15 of 20 patients receiving sodium oxyferriscorbone (75%) and in 7 of 20 patients receiving placebo (35%). Patients receiving sodium oxyferriscorbone experienced less pain and required less antacid than those receiving placebo (P less than 0.05). Side effects were reported in 12 patients, 7 while receiving sodium oxyferriscorbone and 5 while receiving placebo. Six patients did not complete the study due to ulcer complications. Routine laboratory tests revealed no persistent abnormalities that could be related to the treatment. Five placebo-treated patients that were therapeutic failures were switched to sodium oxyferriscorbone and healing was observed within 3 weeks. It is concluded that sodium oxyferriscorbone is effective in enhancing healing of gastric ulcers.

2,3-Diketogulonic Acid↗