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Biomedical subjects

F Pons Romero

Publications and source records attributed to F Pons Romero.

At least 37 records · Page 2Linked to original sources

Acute hepatitis by Listeria monocytogenes in an HIV patient with chronic HBV hepatitis.

We report a young male IVDA with CAH caused by HBV who was infected with HIV and who contracted listeriosis in the form of acute hepatitis and bacteremia, with epithelioid granulomas in the liver. Treatment with ampicillin and a aminoglycoside for 3 weeks was followed by rapid and maintained improvement. Involvement of the liver is unusual in listeriosis and, as far as we are aware, it has not been described previously in patients with HIV infection.

AIDS-Related Opportunistic Infections↗

Interleukin-1 in alcoholic cirrhosis of the liver: the influence of nutrition.

Interleukin-1 (IL-1) is a cytokine produced by the macrophage-monocyte system that has important effects on immunological responses and inflammatory reactions. Several clinical studies have shown that severe protein energy malnutrition adversely effects cell-mediated immune responses and the functional state of macrophages. The objective of this study was to analyse IL-1 production by adherent cells stimulated in vitro with lipopolysaccharide B (LPS) from patients with alcoholic cirrhosis of the liver and its possible relationship with nutritional states. Forty-five patients with alcoholic cirrhosis and 28 healthy donors were investigated. A combined index of nine anthropometric and biochemical parameters was used to evaluate nutritional status of cirrhotic patients, allowing a distinction to be made between those patients with acceptable nutrition (group I: 40%), those with slight malnutrition (group II: 37.7%), and those with severe malnutrition (group III: 22.3%). IL-1 activity was significantly lower in the cirrhosis patients than in the controls (P less than 0.001). This activity also was significantly lower in samples obtained from cirrhotics with severe malnutrition than in those with acceptable nutrition (P less than 0.05); the combined index and the sole anthropometric index gave the same results, suggesting that malnutrition may play a role in the immunoregulatory disturbances in the pathogenesis of alcoholic liver disease.

Adult↗

[Prospective study of the prognostic value of C reactive protein, alpha 1-antitrypsin and alpha 1-acid glycoprotein in acute pancreatitis].

Early recognition of severity of acute pancreatitis is very uncertain. For this reason it is necessary to have objective criteria to predict with accuracy the course of the disease. The aim of this study was to examine the value of the determination of the acute phase reactants: C reactive protein (CRP), alpha 1-antitrypsin (alpha-AT) and alpha 1-glycoprotein acid (alpha-GA) as prognostic indicators of acute pancreatitis on admission and on the third day. We have studied 40 patients with acute pancreatitis and serum concentrations of CRP, alpha-AT and alpha-GP were related to the Ranson Index. On admission the median levels of CRP: 74 mg/L, alpha-AT: 208 mg% and alpha-GA: 303 mg% were significantly higher (p less than 0.001) in patients with Ranson Index greater than or equal to 3 than in those with Ranson Index less than or equal to 2 (CRP: 166 mg/L, alpha-AT: 303 mg% and alpha-GA: 121 mg%). The values which differentiated patients with better and worse prognosis were: CRP 100 mg/L (sensitivity 100% and specificity 86%); alpha--AT 275 mg% (sensitivity 71% and specificity 85%); and alpha-GA 90 mg% (sensitivity 87.5% and specificity 57.9%). CRP, and to a lesser degree the alpha-AT and alpha-GA, were related to the duration of the ileus, and to the severe complications of the acute pancreatitis.

Acute Disease↗

Interleukin-2 and natural killer activity in acute type B hepatitis.

Natural killer (NK) cell activity against K562 cell line, and interleukin-2 (IL-2) activity in supernatants from lectin-activated PBMC cultures from 17 patients with acute hepatitis B in the early phase of illness were studied. These patients showed enhanced NK cytotoxicity and higher levels of IL2 activity as compared with control subjects. There was a positive correlation between cytotoxicity values and levels of IL2 activity. Furthermore, in the recovery phase of illness there was a tendency towards normalization in both parameters. When patients were divided in accordance with markers of HBV replication, HBV-DNA positive patients showed increased NK cell activity and IL2 levels as compared with the control group, whereas in HBV-DNA-negative patients no differences were found. However, no differences were found between patients with HBeAg and patients with anti-HBe. These results suggest that natural cytotoxicity is increased early in the course of acute hepatitis B, while NK cell activity returns to normal later, during convalescence. Enhanced NK cell activity appears to be secondary, at least in part, to increased production of IL2. Natural cytotoxicity may be one mechanism that controls the HBV infection before other cytotoxic mechanisms become fully operative.

Acute Disease↗

[Natural killer (NK) cells and interleukin 2 (IL-2) in Crohn disease].

An analysis was made of spontaneous Natural Killer (NK) activity, the proportion of NK cells and Interleukin 2 (IL-2) production in response to a phytohemagglutinin (PHA) using isolated mononuclear peripheral blood cells from 27 patients with Crohn's disease (CD) and 27 healthy controls. The results obtained showed a decrease in NK activity in comparison with the control group (p less than 0.05), occurring mainly in patients in whom the disease was in an active phase (p less than 0.005), with no apparent relationship to the proportion of NK cells. IL-2 production was, however, similar to that of the healthy controls. A positive correlation between spontaneous NK activity and IL-2 production was evident. The origin of these findings is controversial, suggesting that other factors with a negative modulating effect may inhibit NK function.

Adolescent↗

Could alpha 1 antitrypsin deficiency have any role in the development of celiac sprue after gastric operations?

We report a 50-year-old woman with alpha 1 antitrypsin deficiency (PiSZ phenotype) who developed clinical features of malabsorption after vagotomy and pyloroplasty. The intestinal biopsy demonstrated total villous atrophy with hypertrophy of the crypts. After gluten withdrawal, digestive function and the appearance of the intestinal biopsy returned to normal. We raise the possibility of an association between alpha 1 antitrypsin deficiency and celiac sprue.

Celiac Disease↗

Acute pancreatitis in hepatitis A infection.

Hepatitis viruses are an uncommon cause of acute pancreatitis. We present the case of a boy with acute pancreatitis complicating viral hepatitis with satisfactory recovery. The finding of IgM-anti HAV antibodies implicates hepatitis A virus as the cause.

Acute Disease↗

Laparoscopic diagnosis of tuberculous ascites.

We report 14 patients with tuberculous peritonitis presenting as persistent and exudative ascites. We found a primary site of tuberculous infection in only 10% of the patients. PPD test was positive in 9 patients. Ascitic fluid showed a protein content in excess of 3.5 g/dl. and more than 300 cells/mm3, mainly lymphocytes, in all patients, Ziehl stain and the culture for Tb. bacilli were negative in all cases. The confirmatory diagnosis was made by laparoscopy and peritoneal biopsy. Good views were obtained on all occasions, and there was no morbidity. Appearances were similar in all cases. Multiple white tubercles were scattered over the parietal and visceral peritoneum. filmy adhesions were present. Four patients had cirrhotic liver disease confirmed by laparoscopy. The biopsy specimen showed caseating granulomata, and the auramine stain was positive in four cases. We conclude that laparoscopy and biopsy is a safe and effective method of obtaining an early diagnosis in patients with tuberculous ascites, especially if they also have cirrhosis.

Adult↗