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Biomedical subjects

J Alsina

Publications and source records attributed to J Alsina.

At least 109 records · Page 6Linked to original sources
PubMed1985

Renal allograft rupture: surgical treatment by renal corsetage with lyophilized human dura.

We report 5 cases of renal allograft rupture in which diagnosis was established early through clinical data, laboratory tests and echography. Immediate surgery confirmed the suspicion in all cases. Acute rejection was present in 4 patients and in 1 the previous surgical puncture from the perirenal collection demonstrated serohematic fluid with a biological character similar to that of lymph. This latter case seemed to confirm the suspicion that any process associated with edema in a kidney with obstructed lymphatic tracts (meticulous lymphatic ligatures during donor extraction) is capable of causing a rupture. Conventional surgical treatment is dangerous and insecure on an edematous and friable kidney, resulting in a nephrectomy rate of 55.7 per cent and a postoperative death rate of 8 per cent. Hematoma evacuation, hemostasis by local compression and tridimensional containment of the ruptured areas should be the principles of this operation. By means of renal corsetage with lyophilized human dura these principles can be achieved. This surgical technique, which is simple and secure, its variations and future possibilities are described. In 3 of our 5 patients corsetage with lyophilized human dura was applied. All 5 grafts have taken. Renal function is good in 3 cases and acceptable in 2 at followup between 2 and 15 months.

Adult↗
PubMed1985

Humoral and cellular immunological abnormalities in hypertensive patients.

A high frequency of immunological disturbances were recorded in 19 mild and 23 malignant hypertensive patients. IgG levels were raised in patients who survived a malignant phase of hypertension. We also found increased frequency of autoantibodies (26% vs. 9% in controls), increased T-lymphocyte reactivity against arterial-wall antigens (p = 0.001), a significant frequency of low responders to PHA (p = 0.003), and a statistically significant correlation (p = 0.031) between the presence of autoantibodies and T-cell hyper-reactivity against arterial antigens in mild hypertensive patients. We suggest that these abnormalities might be relevant in the pathogenesis of some hypertensive conditions. Autoantibody production is likely to be correlated with a predisposition to hypertension through some autoimmune mechanisms.

Adult↗
PubMed1982

Captopril in essential hypertension.

1 Forty-one patients with essential hypertension, stages I, II, and III, were treated with captopril alone or in combination with hydrochlorothiazide. Forty two percent were responsive to captopril alone, while the remaining 58% also required the diuretic. The need for the diuretic was related to the phase of hypertension. 2 There was no significant relation between drug response and plasma renin activity. Serum concentrations of creatinine and potassium remained normal, and there were no pathological changes in serum glucose, cholesterol, uric acid concentrations, erythrocyte count, packed cell volume, haemoglobin, or heart rate. 3 Captopril was well tolerated. One patient developed a rash and another ageusia, which disappeared spontaneously. A third, who was also taking allopurinol, developed leucopenia but it disappeared after treatment was withdrawn. There were no cases of proteinuria attributable to captopril; and proteinuria disappeared in four of five patients who were proteinurin before the start of treatment. 4 These findings suggest that doses of captopril of 150 mg to 300 mg (with or without a diuretic) may be adequate for controlling the blood pressure of most patients with essential hypertension.

Adult↗
PubMed1981

[Renal disease with glomerular involvement during Brucella infection (author's transl)].

Renal involvement during Brucella infections has been known for several years, and its real frequency appears to be higher than initially suspected. This case report deals with a patient with positive blood cultures and seroagglutination to Brucella mellitensis who presented transitory renal failure, proteinuria, and macroscopic hematuria. Renal histopathology disclosed the existence of acute tubular necrosis, and the immunofluorescence study revealed the presence of mesangial deposits of immunoglobulins and complement. Electron microscopy demonstrated the presence of electron-dense paramesangial deposits. These data suggest that immunological mechanisms are implicated in the glomerular involvement of Brucella infections.

Acute Kidney Injury↗
PubMed1981

Familial hypocomplementemic hemolytic uremic syndrome with HLA-A3,B7 haplotype.

We describe a familial, relapsing type of hemolytic uremic syndrome (HUS) that has a possible genetic origin. Three members of a family, aged between 15 months and 34 years, evidenced HUS. Histological examination disclosed thrombotic microangiopathy. Recurrences, persistent hypocomplementemia, and the HLA haplotype A3,B7 were a common factor. We studied 17 members of this family and found a low C3 level from activation of the alternative pathway in the haplotype A3,B7 carriers. These three patients with HUS probably had a congenital and hereditary condition in which immunologic factors played a role in its pathogenesis.

Adult↗