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Biomedical subjects

F Vilardell

Publications and source records attributed to F Vilardell.

At least 55 records · Page 3Linked to original sources
PubMed1989

Efficacy of ethanolamine and polidocanol in the eradication of esophageal varices. A prospective randomized trial.

A prospective randomized trial has been undertaken to compare the efficacy of two sclerosing agents, Ethanolamine oleate (Et) and Polidocanol (Pl), in the eradication of esophageal varices (EV). Fifty consecutive cirrhotic patients, 22 in the Et and 28 in the Pl group, were included. Clinical data were comparable in both groups. Eradication of the EV was achieved in 81% (18/22) in the Et group and 64.1% (18/28) in the Pl group (p = NS). There was a significant difference in the rate of rebleeding (4 episodes in 3 patients in the Et group and 18 episodes in 13 patients in the Pl group, p less than 0.05). No differences were noted in the number of other complications or mortality. Both sclerosants have proved useful in the eradication of EV, but Et was superior to Pl in the preventation of recurrent bleeding in the course of repeated endoscopic injection sclerotherapy (EIS).

Esophageal and Gastric Varices↗
PubMed1989

Gastric emptying in marathon runners.

Radionuclide gastric emptying studies using 99m-Tc human serum albumin egg omelette have been carried out in 10 long distance runners at rest and during a 90 minute run at sustained speed. Resting values are compared with controls comprising 10 sedentary subjects. Runners show a significantly accelerated basal gastric emptying (runners t 1/2 = 67.7 (5.9) min; sedentaries t 1/2 = 85.3 (4.5) min, p less than 0.001). The exercise had no significant effect on gastric emptying in these trained subjects (exercise t 1/2 = 66.8 (5.9) min, p = NS), suggesting adaptation to exercise.

Adaptation, Physiological↗
PubMed1989

[Variation of C3 in ascitic fluid from cirrhotic patients subjected to intestinal sterilization or selective intestinal decontamination].

Patients with liver cirrhosis with ascites and low levels of C3 and Total Proteins in ascitic fluid show a greater predisposition to the development of spontaneous bacterial peritonitis. The variation of C3 and Total Proteins levels in ascitic fluid in two groups of patients with liver cirrhosis was studied. Group I (n = 14) underwent intestinal sterilization (n = 7) or selective intestinal decontamination (= 7). Group II was a control. A statistically significant increase in C3 (p less than 0.01) and Total Proteins (p less than 0.015) levels in ascitic fluid in Group I patients was found. There were no changes in the control group. The incidence of side effects was higher in those patients who underwent intestinal sterilization. Our results suggest that selective intestinal decontamination may be useful as a prophylactic measure against spontaneous bacterial peritonitis in those patients with liver cirrhosis at high risk of infection by increasing the bactericidal capacity of ascitic fluid.

Adult↗
PubMed1988

Low C3 in cirrhotic ascites predisposes to spontaneous bacterial peritonitis.

The risk of developing spontaneous bacterial peritonitis (SBP) in relation to the concentration of C3 in ascitic fluid (AF) has been studied prospectively in 33 patients with cirrhosis of the liver, seven of whom had one or more episodes of SBP during hospitalization. C3 concentrations in the AF of patients who developed infection (9.0 +/- 2.67 mg/dl) were significantly lower than in those who did not (18.26 +/- 8.11 mg/dl) (P less than 0.01). C4 concentrations were similar in both groups. A direct correlation was found between AF C3 and total protein concentrations (P less than 0.001). We conclude that a low C3 concentration in AF may predispose to SBP.

Aged↗
PubMed1988

Endoscopic hemostasis by local injection of epinephrine and polidocanol in bleeding ulcer. A prospective randomized trial.

The present prospective randomized trial has been carried out to assess the efficacy of the endoscopic injection of epinephrine plus polidocanol, in the prompt treatment of upper gastrointestinal bleeding due to peptic lesions. Over a period of one year, 72 patients were admitted to the study. Thirty-six of these underwent endoscopic treatment (group A), while the others received medical treatment (group B). Definitive hemostasis was achieved in 29 patients in group A, and in 21 in group B (p less than 0.05). Seven patients in group A and 12 in group B underwent emergency surgery for persistent or recurrent bleeding (p = NS). Three patients from group B received endoscopic treatment owing to relative surgical contraindications. It was successful in all of them. Patients from group A needed a significantly lower number of units of packed red cells (p less than 0.05). Our results show that it is justified to employ endoscopic injection as the first therapeutic step in upper GI bleeding due to peptic gastroduodenal lesions.

Adult↗
PubMed1988

Laparoscopic cytology--an evaluation.

Cytological sampling by abrasion and/or aspiration was done in a consecutive series of 927 patients at the time of laparoscopy. Cytological examination confirmed the diagnosis of malignancy in 312 out of 335 cases of primary or secondary liver cancer (93.1%). Biopsy was positive in 262 out of 303 patients (86.4%). The combined use of cytology and biopsy provided a positive diagnostic accuracy of 97.6%). The cytological report was positive in 215 out of 239 (89.9%) proven extrahepatic malignancies (gallbladder, gynecological, peritoneal). Biopsy was positive in 180 out of 199 cases (90.4%). The combined use of cytology and biopsy provided an accuracy of 95.8%). There was only one false positive diagnosis of malignancy. The sensitivity of laparoscopic cytology was 93.1% and its specificity 100% in liver disease. Sensitivity was 90.3% and specificity 99.4% in other types of abdominal cancer. In these series, cytological examination added 15.6% positive results (liver) and 11.7% (other lesions) to those of biopsy, which was not performed in 89 patients in whom it was considered too risky or technically too difficult.

Biopsy↗
PubMed1988

Gastric emptying after truncal vagotomy and pyloroplasty.

We have studied the gastric (fundic and antral) emptying of solids and liquids by a radionuclide method in 20 patients after truncal vagotomy and pyloroplasty (TVP) and in 10 control subjects. Gastric emptying of solids in TVP patients was similar to that of the control group (NS), but fundic emptying did not show a lag phase and was significantly faster. A significantly higher percentage of the solid fraction of the test meal filled the antrum (32 +/- 16% versus 20 +/- 9%; p less than 0.05), and this quantity was constant during the study period. Gastric emptying of liquids was greatly hastened after surgery. In 22 min 50 +/- 16% had left the stomach (versus 40 +/- 14% in controls; p less than 0.001). At 90 min the amount of liquid remaining in the stomach was similar to that in the control subjects. TVP accelerates fundic emptying of solids, which are transferred to an overfilled, paretic antrum. Liquids are emptied by a bimodal pattern with a precipitous initial emptying followed by a second slower phase.

Adult↗
PubMed1988

Education and training in gastroenterology. Report from the OMGE symposia at the International Congress of Gastroenterology, Lisbon, Portugal, September 1984, and at the 8th World Congress of Gastroenterology, São Paulo, Brazil, September 1986.

Gastroenterology is recognized as a speciality in most countries, especially in Europe and North America. The requirements for being acknowledged as a specialist vary from 1 1/2 to 4 years of training and education in gastroenterology in addition to 1-6 years of training and education in internal medicine/surgery. The requirement of theoretical education varying from 40 to 300 h is practiced in some countries only. In some countries training in endoscopy is separated from gastroenterology. A formal examination and post-specialization training program is required in only some of the countries answering the questionnaire. The number of centres per million inhabitants recognized for training and education also varied greatly. The number of specialists per million inhabitants was 3.6 to 15. In the Middle and Far East the organisation of gastroenterology was much inferior to that in Europe and North America because of insufficient education and organization programs and lack of economic support to perform them. The answers from the gastroenterological associations and personal reporters agreed on the following: A speciality in medical and surgical gastroenterology should be established in all countries around the world. Programs for training and education should be agreed upon in recognized teaching and training institutions of gastroenterology, probably of 3 years' duration in combination with a speciality in internal medicine. A gastroenterologist will in most cases be dealing with other diseases as well. The number of specialists per million inhabitants may be estimated to 10, the exact number not being possible to determine at present. In most countries the post-specialization programs were not required but were offered, a problem that has to be clarified.(ABSTRACT TRUNCATED AT 250 WORDS)

Congresses as Topic↗
PubMed1987

Circulating immunoreactive somatostatin in gastrointestinal diseases. Decrease after vagotomy and enhancement in active ulcerative colitis, irritable bowel syndrome, and duodenal ulcer.

The main source of circulating immunoreactive somatostatin (IRS) seems to be the gastrointestinal tract. We therefore investigated plasma IRS in patients with various gastrointestinal diseases. Mean basal IRS oscillated between 46 and 73 pg/ml. A postprandial rise was observed in all patients and age-matched controls. However, the increment was significantly higher in patients with duodenal ulcer (159 +/- 20 pg/ml), active ulcerative colitis (176 +/- 17 pg/ml), and irritable bowel syndrome (194.4 +/- 20.4 pg/ml). Patients with duodenal ulcers who underwent vagotomy showed a decreased postprandial increment (107 +/- 10 pg/ml) when compared with active duodenal ulcer patients. No difference was demonstrable between controls and individuals with gastric ulcer, and patients with inactive ulcerative colitis. These results suggest that vagal innervation plays a role in postprandial IRS stimulation, whereas gastric hyperacidity, acute lesions of the colonic mucosa, and hypermotility of the gastrointestinal tract are associated with an exaggerated postprandial IRS response. Since somatostatin is known to influence many gastrointestinal functions, these variations in circulating IRS concentrations may be of pathophysiologic importance.

Adult↗
PubMed1986

Renal prostaglandins in cirrhosis of the liver.

Urinary prostaglandin excretion was studied in 42 patients with liver cirrhosis and in nine control subjects on restricted sodium intake and on bed rest. Creatinine clearance (CCr), sodium excretion (UNaV), plasma renin activity (PRA) and plasma aldosterone were also evaluated. Patients without ascites and ascitic patients without renal failure showed increased urinary excretion of immunoreactive 6-ketoprostaglandin F1 alpha (i6-keto-PGF1 alpha), prostaglandin E2 (iPGE2) and thromboxane B2 (iTXB2) when compared with controls, while immunoreactive PGF2a (iPGF2 alpha) levels did not differ from those in the control group. Patients with functional renal failure (FRF) presented a significant reduction of vasodilator prostaglandins but urinary excretion of iTXB2 was higher than in controls. On the whole, cirrhotic patients with higher urinary excretion of prostaglandins had normal or nearly normal PRA and aldosterone levels. i6-keto-PGF1 alpha and iPGE2 inversely correlated with PRA and aldosterone. The relationship between i6-ketoPGF alpha alpha and CCr was found to be highly significant in cirrhotic patients but not in the control group. On the other hand, iPGE2 significantly correlated with UNaV and with the fractional excretion of sodium (FENa). We concluded that: (a) enhanced renal prostaglandin synthesis in cirrhosis, inversely related to PRA and aldosterone, may be dependent on volume status; and (b) preserved renal function in these patients is associated with the ability to synthesize prostacyclin and PGE2.

6-Ketoprostaglandin F1 alpha↗
PubMed1986

Effect of sulindac on prostaglandin excretion and renal function in cirrhotic patients with ascites.

The effect of sulindac, a nonsteroidal anti-inflammatory drug, on renal prostaglandin synthesis and renal function variables was investigated in six cirrhotic patients with tense ascites and marked sodium retention. We studied serum thromboxane (TXB2) production, urinary prostaglandin excretion (6-keto-prostaglandin F1 alpha and TXB2) and renal function before and after administration of a therapeutic dose of sulindac (400 mg). After treatment, no significant changes were observed in urinary prostaglandin excretion, serum creatinine concentration, urine volume, or urinary sodium and creatinine clearance, whereas the serum TXB2 concentration was reduced in 89%. In five patients systemic prostaglandins were inhibited, but renal excretion remained unchallenged. However, one patient showed marked reduction of urinary prostaglandins associated with a depression of renal function. The study suggests that sulindac could be a safe substitute for other nonsteroidal anti-inflammatory drugs in cirrhotic patients with ascites. Further pharmacological trials seem to be warranted.

Ascites↗
PubMed1985

Percutaneous cholangiography in the diagnosis of hepatic fascioliasis.

A case of hepatic fascioliasis is reported in which the diagnosis was made by direct visualization of the parasite by means of percutaneous transhepatic cholangiography. The peculiar radiological image should be included in the differential diagnosis of biliary tract pathology.

Cholangiography↗