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Biomedical subjects

C Aguirre Errasti

Publications and source records attributed to C Aguirre Errasti.

At least 19 recordsLinked to original sources

[Acute adrenal insufficiency caused by bilateral adrenal hemorrhage as first manifestation of antiphospholipid syndrome. Report of a case and review].

Although adrenal hemorrhage is an unusual feature of antiphospholipid syndrome (APS), it can be its first clinical manifestation. The pathogenetic substratum is the thrombosis of the adrenal veins leading to hemorrhagic infarction. Recurrences are frequent in patients with APS-related thrombosis, thus long-term anticoagulation is advocated by most authors.

Acute Disease↗

[Population reference ranges and determinants of plasma homocysteine levels].

BACKGROUND: There is a well-known relationship between plasma homocysteine levels and the risk of cardiovascular events. Determination of homocysteine levels may also be of potential diagnostic aid in several clinical situations. The construction of reference ranges should take age and sex variations into account. SUBJECTS AND METHODS: 396 healthy subjects were recruited (172 males and 224 females). Fasting plasma homocysteine levels were measured using the fluorescein polarization immunoassay technique (FPIA). Plasma levels of creatinine, folates, vitamin B12 and TSH were measured. 90% reference ranges were estimated by fractional polynomial regression methods. RESULTS: Homocysteine plasma levels ranged from 4.35 micromol/l to 17,71 micromol/l (median 8.62 micromol/l). These concentrations increased with age and were higher in males (median 9.53 micromol/l [range: 5.45-17.5]) than in females (median 7.79 micromol/l[range: 4.35-17.71]). Sex differences decreased in the elderly. Creatinine plasma levels (with a positive association) and folate levels (with a negative association) had a statistically significant effect on the specific distribution of homocysteine levels according to age and sex. CONCLUSIONS: Age-and sex-specific reference ranges of plasma homocysteine have been defined. Renal function along with folate plasma levels have to be accounted for when assessing these distribution ranges.

Adult↗

[Study of cobalamin deficiency in gastrectomized and aged subjects].

OBJECTIVE: The objective of this study were: a) to investigate vitamin B12 deficiency among and advanced aged, clinically healthy, asymptomatic population, presumably with a high prevalence of vitamin B12 deficiency. This deficiency was defined as an increase in the MMA/creatinine ratio in urine and/or basal plasma HT levels which normalize after the administration of vitamin B12; b) its relationship with plasma vitamin B12 levels. SUBJECTS AND METHODS: A total of 45 subjects were studied, 19 in the Group of Gastrectomized patients, who were selected on the basis of an age over 60 years and partial gastrectomy of more than five years, and 26 in the Geriatric Group selected in two nursing homes. All of them were asymptopatic and "healthy" according to data in the clinical records and clinical examination, analytical studies, and none of them was taking any drug that might alter results. After basal analytical studies, which included B12, folates, metilmalonic acid/creatinine (MMA/creatinine) in urine and total plasma homocysteine (TH), i.m. vitamin B12 was administered for 15 days to the gastrectomized patients and oral B12 for 28 days with 2.5 mg folic acid for the last 14 days to the patients in the Geriatric Group. Basal analytical studies were repeated at the end of the study. RESULTS: Basal analytical studies were normal with the exception of two subjects with low levels of hemoglobin and 8 with decreased MCV. Only one subject had decreased serum cobalamines. Nine subjects (20%) were identified with increased basal levels of MMA/creatinine which normalized after decreasing between 97% and 12% after the administration of vitamin B12. TH and MCV also decreased significantly. Basal levels of vitamin B12 ranged from 244 pg/ml to 483 pg/ml (n = 220 pg/ml-980 pg/ml). CONCLUSIONS: Vitamin B12 deficiency, defined as an increase in the MMA/creatinine ratio and TH normalized with B12, is highly prevalent among elderly subjects and may occur in absence of clinical and/or analytical manifestations. Given the widespread recommendation of quantitating MMA and TH for the diagnosis of borderline cases of vitamin B12 deficiency, such disturbance may occur in clinically and biochemically normal subjects. Thus, a special caution should be exerted, given the existing comorbidity in advanced ages, before attributing B12 deficiency to a condition which may be the expression of another concomitant condition.

Age Factors↗

[Recurrent polychondritis associated with ulcerative colitis].

Relapsing polychondritis and Ulcerative Colitis is an uncommon association that has been described only ten times in medical literature. We report a new case of this association in which it was necessary to treat with azathriopine to stop disease progression. Relapsing Polichondritis is a disorder to be considered in patients with Ulcerative Colitis and inflammation of the cartilagenous structures.

Adult↗

[Pyogenic sacroiliitis. Presentation of 10 cases].

We report the clinical, radiological and microbiological features of ten patients diagnosed of pyogenic sacroiliitis in an Internal Medicine Department during a 13 years period. Clinical signs and radiological or scintigraphical findings were present in every case. Staphylococcus aureus was isolated in blood cultures in eight cases. We remark mean age (26.2 years), male predominance and the high prevalence of intravenous drug abuse as the main epidemiological data in our patients. Onset was acute in 60% of the cases, and subacute in the others. Erythrocyte sedimentation rate and a high white blood cell count were uniformly elevated among laboratory tests. Initial roentgenograms were normal in 60%. Bone scans were the most sensitive diagnostic aid. All the patients were treated with intravenous cloxacilin between two and eight weeks; aminoglycosides were added in four patients. We have observed two cases of psoas abscesses that required surgical drainage.

Adolescent↗

[The use of thymostimulin in lymphoma and myeloma patients].

The benefit of the immunomodulation properties of thymic hormones in patients receiving chemotherapy for malignant diseases is yet to be defined. The efficacy of thymostimulin (TP-1) on hematological tolerance is evaluated, the performance level, the number and severity of the infections and skin reactions in two groups of homogeneous and randomized patients, diagnosed as having lymphoma and myeloma. Both patient groups (receiving or not receiving treatment) consisted of 20 persons. This observation was carried out in 96 courses of chemotherapy in each group; no significant differences having been noted in respect of the performance status at the beginning nor at the end of the study period between the 2 treatment groups. The hematological tolerance to chemotherapy, skin reactions and number and severity of infections registered were not significantly different between the 2 groups. In conclusion, we were unable to confirm an improvement in the clinical parameters of the myeloma and lymphoma patients receiving chemotherapy and thymostimulin during the period of observation.

Hodgkin Disease↗