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D Sanz Guajardo

Publications and source records attributed to D Sanz Guajardo.

At least 19 recordsLinked to original sources
PubMed2005

Therapy of intractable pruritus with MARS.

INTRODUCTION: Pruritus is the most disabling symptom in patients with cholestatic liver diseases. Many drug therapies have been used for the treatment of these diseases, with different outcomes. The molecular adsorbent recirculating system (MARS) has been used in the treatment of intractable pruritus in cholestatic syndromes. We report our experience with MARS in 3 patients with intractable pruritus on the waiting list: 2 liver transplant recipients and a patient with primary biliary cirrhosis. PATIENTS AND RESULTS: Two middle-aged women and 1 middle-aged man, who were recipients of an orthotopic liver transplant for primary biliary cirrhosis, underwent three (n = 2) and two (n = 1) 6-hour sessions of MARS due to medically uncontrollable pruritus. All noted marked improvement of pruritus, with decreased bilirubin levels, but this improvement lasted only a few days in all cases. We observed no changes in transaminase or albumin levels, or prothrombin time. Complications included an episode of angina due to anemia caused by jugular catheter bleeding, and thrombocytopenia in all patients. CONCLUSIONS: MARS is an effective treatment for intractable pruritus in cholestatic liver diseases, although its beneficial effect is short. This extracorporeal liver device is safe, because most related adverse events are mild.

Adult↗
PubMed1997

[Randomized, comparative study to evaluate efficacy and safety of doxazosin versus nitrendipine in the treatment of mild to moderate hypertension].

Doxazosin, an alfa-1 adrenoceptor antagonist, was compared with nitrendipine, a calcium antagonist, to evaluate their efficacy and safety in 61 patients with mild to moderate hypertension. 31 patients were assigned randomly to receive 1-16 mg of doxazosin and 30 patients were assigned to 10-20 mg of nitrendipine during 14 weeks (10 weeks of titration and 4 weeks of maintenance). Mean final dose was 6.1 mg for doxazosin and 15.6 mg for nitrendipine. Both treatments reduced supine and standing diastolic and systolic blood pressure (p < 0.01 for all comparisons). 22 patients in the doxazosin group (78.6%) and 18 in the nitrendipine group (78.3%) were considered therapy successes. There were not clinically significant changes in laboratory tests for both groups. Global assessment of adverse events was similar for both treatments (46.7% for doxazosin and 44.8% for nitrendipine), although patients treated with nitrendipine presented facial rush (20%) against none of the doxazosin group (p < 0.05). Withdrawals due to adverse events were higher in the nitrendipine group than in the doxazosin one (20.7% versus 6.7%, p = 0.14). The results of this study confirms that both antihypertensives reduced blood pressure in patients with mild to moderate hypertension. Furthermore, doxazosin treatment demonstrates a fewer number of withdrawals caused by adverse events.

Adrenergic alpha-Antagonists↗
PubMed1980

[Plasmapheresis in the treatment of extracapillary glomerulonephritis (author's transl)].

Seven patients with widespread proliferation of the capilar epithelium producting glomerular crescents in more than 80 percent of the glomeruli have been studied. Three patients had a systemic lupus erythematosus, two had primitive extracapillary glomerulonephritis, one had panarteritis nodosa, and another a Schönlein-Henoch syndrome. All patients presented severe renal failure when plasmapheresis was begun. Hemodialysis was needed in four cases. The remained three patients showed creatinine clearance values of 8, 20, and 30 ml/min, respectively. Search for immune complexes was negative in all cases. Plasmapheresis were applied within 1 to 7 months of the onset of the disease in alternate-day sessions. Duration of treatment varied between 1 to 5 months. Moreover, prednisone, cyclophosphamide and azathioprine were given to all patients. Values of creatinine clearance rised to 71, 49 and 18 ml/min in the two patients with primitive extracapillary glomerulonephritis and in the patient with panarteritis nodosa, respectively. Renal function improvement was not achieved in the three patients with systemic lupus erythematosus and in the patient with Henoch's purpura.

Arteritis↗
PubMed1979

[Polycystic kidneys in adults. A clinical study of 106 cases (author's transl)].

A series of 106 cases of polycystic kidneys in adults is presented. The main clinical, exploratory and therapeutic data are analyzed. The average age of the patients at the time of the first clinical manifestation was 35 years; average age at the time of diagnosis was 43 years. The most common forms of presentation included renal colics, blood hypertension, noncolic lumbar pain, macroscopic hematuria, and polydipsia-polyuria. The most frequent symptoms were: abdominal pain of any type (73 patients), polydipsia-polyuria (66 patients), blood hypertension (61 patients), macroscopic hematuria (47 cases), episodes of urinary infection (41 cases), and passing of calculi (22 cases). Seventy-eight subjects had arterial high blood pressure; it was easily controlled in all except 14 cases. Proteinuria was slight in all except two cases. Values for hematocrit and hemoglobin remained high in relation to the degree of renal insufficiency. The mean value of hematocrit in patients with creatinine clearance below 10 ml/min was 30 percent. Renal function decreased gradually, from normal to a clearance of less than 10 ml/min over a period of 12 years on the average. Diagnosis was based mainly on abdominal physical examination and intravenous urography; 89 patients had palpable abdominal masses. Urography revealed typical images of polycystic kidney in every case. The following associated conditions were also discovered: liver cysts (17 cases among 57 liver scanning; bilateral ovarian cysts in one case; Cacci-Ricci's disease in one case; and cerebral arterial aneurysms in another patient. Treatment was conservative with the aim to control arterial blood pressure and urinary infection. Twenty-nine patients required saline replacement; peritoneal dialysis was practiced in two cases and permanent hemodialysis was prescribed for 15 individuals.

Adolescent↗
PubMed1979

[Clinical course and recurrences of the nephrotic syndrome due to minimal histologic lesions. Review of 73 cases (author's transl)].

The clinical course of 73 patients with nephrotic syndrome due to minimal histologic lesions was studied. A renal biopsy was performed in all of the cases; 23 biopsies were studied by immunofluorescence and two renal biopsies were carried out in eight cases. The follow-up period varied from 6 months to 10 years. The following treatment were used: 23 patients received prednisone alone, 48 were given prednisone plus chlorambucil, and 2 were treated only with chlorambucil. Sixty-five patients achieved a complete remission; a total of 39 recurrences occurred in 23 of them. The relapses took place 16 months on the average following complete remission. Twenty-three patients (32.4 percent) cured with only prednisone. Forty-eight required the association with chlorambucil, 8 percent of whom experienced recurrences before being completed cured. Two individuals were treated with chlorambucil alone and ach;eved a complete and stable remission. Eight patients (10.95 percent) could not be cured. Five of them showed a glomerular focal hyalinosis in the second renal biopsy. Six patients had hematuria at the onset: two of them achieved complete remission with recurrences; four did not. Three of the latter had glomerular focal hyalinosis. There were small foci of immunoglobulin deposits in 13 cases; 11 of them obtained complete remission with relapses and 2 achieved partial remission.

Adolescent↗