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Biomedical subjects

A Vilches

Publications and source records attributed to A Vilches.

15 recordsLinked to original sources
PubMed2001

[Acute peripheral demyelinating polyneuropathy and acute renal failure after administration of FK506].

FK 506 is a potent immunosuppressive agent in clinical use in solid organ transplantation since 1989. Approximately 5% of patients receiving FK 506 develop major central nervous system toxicity but peripheral nervous system involvement is very uncommon, and there are only 4 reported cases of demyelinating polyneuropathy in patients who received a liver transplant. We report a case of demyelinating polyneuropathy associated with the use of FK 506 in a renal transplant recipient.

Acute Disease↗
PubMed1997

[Attitude and structural barriers detected in primary care physicians towards treating patients with HIV/AIDS infection].

OBJECTIVES: To identify attitudes, knowledge and self-perceived risks among doctors in the Este-Oriente District of Sevilla concerning HIV/AIDS infection; to detect attitude problems and structural barriers affecting doctors' predisposition towards patients with HIV/AIDS infection. DESIGN: A cross sectional study using a self-administered questionnaire. SETTING: Este-Oriente Primary Care district, Sevilla. PARTICIPANTS: Permanent and provisional doctors and paediatricians working in the district during the survey. MEASUREMENTS AND RESULTS: Reply rate was 86% (n = 111). Most doctors (85%) had treated one or more patients with HIV. 91% thought they had to treat these persons. However, 21% would not work with them, if they had the choice. CONCLUSIONS: Attitudes of doctors and paediatricians in the Este-Oriente district of Sevilla towards HIV/AIDS patients can be qualified as positive. Most doctors need to extend their knowledge of this disease. The perception of risk of contagion is high and higher than the real risk. Important attitude and structural barriers to care provision were detected: intervention strategies were proposed by the doctors and paediatricians of this district.

Acquired Immunodeficiency Syndrome↗
PubMed1996

[Incidence, etiology and prognostic value of persistent significant proteinuria in kidney transplants].

We investigated persistent significant proteinuria (PSP), defined as proteinuria > 1 gr/24 hours on three consecutive months, in renal allograft recipients. The clinical records of 273 patients (288 grafts) were reviewed and 236 grafts (178 live related, 58 cadaver donor) that functioned for at least 4 months (230 patients, 148 men and 82 women) were selected for analysis. The histological diagnoses of 226 grafts and 35 native kidneys were also reviewed. PSP was present in 67 grafts (28.4%); 43 of these grafts were studied histologically (transplant glomerulopathy (TxGPT) 19, idiopathic glomerulopathy (GP) 13, and chronic rejection 11). Patients with an idiopathic GP in the graft usually presented with the nephrotic syndrome (65%); this presentation was infrequent in patients with chronic rejection. The appearance of proteinuria was strongly associated with functional deterioration in grafts with chronic rejection and TxGPT; in grafts with PSP and a histological diagnosis of idiopathic GP, renal function was usually normal. Within grafts with PSP no statistically significant differences in actuarial survival (AS) could be established when the time of appearance or magnitude of PSP, the presence or absence of arterial hypertension, the immunosuppressive regimen, and the histological diagnosis were considered. Contrariwise, the difference in AS was highly significant (p < 0.0001) when grafts with and without PSP were compared. The former had an AS at 5 and 10 years of 74.6% and 55.7%, while in the case of the latter AS was 57.3% and 32.1%, respectively. In conclusion, in the present series 28.4% of grafts that functioned 4 months or more presented PSP. The most frequent glomerular lesion was TxGPT. The presence of PSP was a marker for poorer prognosis, since AS at 5 and 10 years was significantly less in this group.

Actuarial Analysis↗
PubMedDate not supplied

Sympathetic nervous system response to graded exercise: effect of beta-blockade.

This study compares the sympathetic nervous system response to graded exercise in normotensive and essential hypertensive subjects with and without beta-adrenergic blockade. Blood pressure (BP), heart rate, and plasma norepinephrine (NE), epinephrine (E), and dopamine (DA) were measured just before starting the exercise (Pre-Ex), in the submaximal exercise (Sub-max),and after 8 minutes rest (Post-Ex). On placebo, Sub-max induced in both normotensives and hypertensives a similar increase in NE and E plasma levels. Plasma DA remained unchanged. Propranolol in controls and propranolol or mepindolol in hypertensives didn't modify significantly: 1) Pre-Ex plasma levels of E, NE, and DA; 2) response at Sub-max in controls; 3) plasma E and DA in hypertensive patients. In hypertensives on beta-blockade, submaximal exercise elicited a greater increase in plasma NE. Values for plasma NE in patients on propranolol were 1135 +/- 229 pg/ml higher than those obtained in the same patients on placebo (p less than 0.001). On mepindolol, the plasma NE increment was higher than that on placebo (p less than 0.05), but lower than that on propranolol (p less than 0.01). In controls, propranolol did not significantly modify BP at Pre-Ex or its response to exercise, whereas systolic and diastolic BP were significantly lower at Pre-Ex, Sub-max, and Post-Ex in hypertensives. On beta-blockade, heart rate decrease in Pre-Ex, Sub-max, and Post-Ex were not different in controls and hypertensives. The differences found on beta blockade would indicate that the effects of beta blockers are not identical in normotensive and hypertensive subjects.

Adrenergic beta-Antagonists↗